National Provider Identifier
Derrick Schutrum
Derrick Schutrum is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Depew, NY and a listed phone number of (716) 608-7040.
Profile Overview
- NPI
- 1295350940
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- June 09, 2020
- Last Updated
- June 09, 2020
Practice Location
- 4893 Transit RD
- Depew, NY 14043-4698
Phone: (716) 608-7040
Mailing Address
- 1961 Bush RD
- Grand Island, NY 14072-2915
Specialties
- Family Medicine Physician (207Q00000X)
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1295350940
- Entity Type
- Individual
- Last Name
- Schutrum
- First Name
- Derrick
- Mailing Street Address
- 1961 Bush RD
- Mailing City
- Grand Island
- Mailing State
- NY
- Mailing ZIP Code
- 14072-2915
- Mailing Country
- US
- Mailing Phone
- (716) 936-4334
- Practice Street Address
- 4893 Transit RD
- Practice City
- Depew
- Practice State
- NY
- Practice ZIP Code
- 14043-4698
- Practice Country
- US
- Practice Phone
- (716) 608-7040
- Enumeration Date
- June 09, 2020
- Last Updated
- June 09, 2020
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- June 09, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X), Physician Assistant (363A00000X)