Individual
DR. JAMES L DEMETROULAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 ENDICOTT ST, SUITE 100, DANVERS, MA 01923-3623
(978) 745-6601
(978) 624-4040
Mailing address
104 ENDICOTT ST, SUITE 100, DANVERS, MA 01923-3623
(781) 639-3055
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
79502
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012294
NEIGHBORHOOD HEALTH NUMBE
MA
01
—
040006919
RAILROAD MEDICARE NUMBER
MA
01
—
079502
TUFTS NUMBER
MA
01
—
1000021
UNITED HEALTH NUMBER
MA
01
—
19486
HARVARD PILGRIM
MA
01
—
2084343
AETNA
MA
05
—
3129101
—
MA
01
—
34544
FALLON NUMBER
MA
01
—
J30549
BLUE SHIELD NUMBER
MA
Enumeration date
02/10/2006
Last updated
12/29/2021
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