Provider Demographics
NPI:1982193405
Name:FARMEN, DEREK
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:FARMEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 INDEPENDENCE POINTE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-2691
Mailing Address - Country:US
Mailing Address - Phone:704-849-9393
Mailing Address - Fax:704-845-8589
Practice Address - Street 1:10550 INDEPENDENCE POINTE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2691
Practice Address - Country:US
Practice Address - Phone:704-849-9393
Practice Address - Fax:704-845-8589
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor