Provider Demographics
NPI:1538141940
Name:DERBER, CATHERINE JANE FORBES (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:JANE FORBES
Last Name:DERBER
Suffix:
Gender:F
Credentials:MD
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 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-8999
Mailing Address - Fax:757-446-7922
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 572
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-8999
Practice Address - Fax:757-446-7922
Is Sole Proprietor?:No
Enumeration Date:2005-11-19
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241825207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1538141940Medicaid
VA407305OtherANTHEM BC/BS
VAPAROtherVA PREMIER HEALTH (EVMS HEALTH SERVICES)
VAPAROtherAETNA
NC5914144Medicaid
VAPAROtherCORVEL/CORCARE (EVMS HEALTH SERVICES)
VAPAROtherVA HEALTH NETWORK
VAPAROtherUNITED HEALTH CARE/MAMSI
VAPAROtherCIGNA
VAPAROtherUSA MANAGED CARE (EVMS HEALTH SERVICES)
VAPAROtherFIRST HEALTH COMMERCIAL/COVENTRY HEALTH/SOUTHERN HEALTH
VA-032OtherTRICARE/CHAMPUS
VA10060443OtherOPTIMA HEALTH
VAPAROtherMULTIPLAN (EVMS HEALTH SERVICES)
VA-032OtherTRICARE/CHAMPUS
VAVAA101008Medicare PIN