NPI

Paul Deramo

This page is a copy of the public NPPES file.

Facts

Status
Active
Credential
M.D.
Type
Individual
Enumeration date
2011-01-14
Last updated
2025-01-29

Specialties

Licenses

License UT
12054791-1205
License UT
12054791-1205

Location

Practice location
3550 N University Ave Ste 250
City
Provo UT
Postal code
84604-6695
Phone
(801) 374-9625

Medicare

PECOS
A PECOS enrollment row matches this NPI.

LEIE

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