Individual provider · Type 1 NPI

Kevin Michael Van Derveer, DO

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1245989854 Active

Practice location

4190 City Ave
Philadelphia, PA 19131-1626

Call (215) 871-6730 Map

Specialties and licenses

TaxonomyCodeLicense
Surgery Physician 208600000X25MB12606300 (NJ)
Surgery Physician 208600000XOS025246 (PA)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1245989854

Kevin Michael Van Derveer, DO's National Provider Identifier is 1245989854, issued on Mar 21, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Jul 29, 2025.