NPI 1053326520

Darrin W Dereu, ATC

Practitioner Athletic Trainer Raleigh, NC

Practice location

Address: N Carolina State University 2500 Warren Carrol Drive, Box 8502, Raleigh, NC 27695-8502
Phone: (919) 513-7295
Mailing address: 3404 Sosa Rd, Raleigh, NC 27610-4097

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 0805 (NC)

Other Specialist/Technologist providers in North Carolina →

Registry record

NPI: 1053326520
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Jul 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.