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Individual
MICHAEL REMY DEMAERTELAERE
Active
Individual
MICHAEL REMY DEMAERTELAERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036105510
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105510
—
IL
01
—
09915014
BLUE CROSS BLUE SHIELD
IL
01
—
649420
MEDICARE PROV NUMBER
—
Enumeration date
11/22/2006
Last updated
03/01/2022
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