Organization
DEMOS AGIOMAVRITIS MD PC
Active
Organization
DEMOS AGIOMAVRITIS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMOSTHENES K AGIOMAVRITIS MD (PHYSICIAN PRESIDENT)
(508) 770-8002
Entity
Organization
Contact information
Practice address
385 GROVE ST, SUITE 120, WORCESTER, MA 01605-3924
(508) 770-8002
(508) 770-8006
Mailing address
385 GROVE ST, SUITE 120, WORCESTER, MA 01605-3924
(508) 770-8002
(508) 770-8006
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47165
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20787175
TAX ID
—
01
—
26373
FALLON
—
01
—
61250
HARVARD PILGRIM
—
01
—
701827
TUFTS
—
01
—
9065240
PRIVATE HEALTH CARE
—
05
—
9751530
—
MA
01
—
999969
NETWORK HEALTH
—
01
—
M18983
BCBS
—
01
—
N01922
BLUE CROSS INDIVIDUAL
—
Enumeration date
01/31/2006
Last updated
08/22/2020
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