Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35.139574 | OH |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD444166 | PA |
N | 207YP0228X | Pediatric Otolaryngology | MD444166 | PA |
NPI | 1801058391 |
---|---|
Provider Name | Dr. Michael A Demarcantonio |
First Address | Cincinnati, OH 45229-3026 |
Second Address | San Antonio, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 03/09/2020 |