Individual
GERALD A DEMASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1902 BRAEBURN DR STE 130, SALEM, VA 24153-7304
(540) 444-0460
(540) 444-0479
Mailing address
2000 HEALTH PARK DR FL HP2, BRENTWOOD, TN 37027-4525
(615) 373-7600
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101250656
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116023007
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164746988
—
VA
Enumeration date
03/23/2010
Last updated
08/31/2020
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