Provider Demographics
NPI:1336335942
Name:FOERSCHLER, DEREK L (DO)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:L
Last Name:FOERSCHLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63038
Mailing Address - Street 2:
Mailing Address - City:MCBH KANEOHE BAY
Mailing Address - State:HI
Mailing Address - Zip Code:96863-3038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BOX 63036
Practice Address - Street 2:BRAVO SURG CO. 3D MED BATTALION
Practice Address - City:KANEOHE BAY
Practice Address - State:HI
Practice Address - Zip Code:96863-3036
Practice Address - Country:US
Practice Address - Phone:808-257-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS021636207L00000X
HIDOS2479207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology