Provider Demographics
NPI:1861507121
Name:DERRING, ELDRIDGE HOPKINS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ELDRIDGE
Middle Name:HOPKINS
Last Name:DERRING
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:113 GAINSBOROUGH SQ
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1713
Mailing Address - Country:US
Mailing Address - Phone:757-547-9451
Mailing Address - Fax:757-547-1405
Practice Address - Street 1:113 GAINSBOROUGH SQ
Practice Address - Street 2:SUITE 300
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1713
Practice Address - Country:US
Practice Address - Phone:757-547-9451
Practice Address - Fax:757-547-1405
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101022505207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA042679OtherANTHEM
VA15195OtherOPTIMA
VAB09962Medicare UPIN