# L.M. DEMIDOWICH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northern Sun Podiatry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134786510
- **Authorized official:** DR. LISA MARIE DEMIDOWICH DPM (MEMBER)
- **Authorized official phone:** (973) 464-7742

## Contact information

- **Practice address:** 2286 CROSSWIND DR STE C, PRESCOTT, AZ 86301-6100
- **Practice address phone:** (973) 464-7742
- **Mailing address:** PO BOX 27077, PRESCOTT VALLEY, AZ 86312-7077
- **Mailing address phone:** (973) 464-7742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 05/21/2019
- **Last updated:** 05/21/2019