Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 00G787720 | CA |
NPI | 1003841735 |
---|---|
Provider Name | Stephanie L Demara |
First Address | Birmingham, AL 35266-0257 |
Second Address | Fortuna, CA 95540-3120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 09/10/2019 |