Individual
JOHN MARK DEMAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2930 HAMILTON BLVD, STE 102, SIOUX CITY, IA 51104-2431
(712) 277-9370
(712) 252-4733
Mailing address
2930 HAMILTON BLVD, STE 102, SIOUX CITY, IA 51104-2431
(712) 277-9370
(712) 252-4733
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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