Individual
JOHN MARK DEMAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
31906
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366447294
MEDICARE INDIVIDUAL NPI
IA
01
—
1417088907
WELLMARK GROUP NPI NUMBER
IA
01
—
DT7736
MEDICARE RR GROUP PTAN
IA
01
—
IB2763
MEDICARE GROUP PTAN
IA
01
—
IB2763001
MEDICARE INDIVIDUAL PTAN
IA
Enumeration date
06/16/2005
Last updated
08/16/2016
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