Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 253127 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME150427 | FL |
NPI | 1326275256 |
---|---|
Provider Name | Michael Demishev |
First Address | West Palm Beach, FL 33407-1901 |
Second Address | Boca Raton, FL 33486-2349 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 05/08/2021 |