Individual
DR. DEMOSTHENES AGIOMAVRITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
367 PLANTATION ST, WORCESTER, MA 01605-2323
(508) 334-1443
(508) 334-1448
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47165
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202787175
CHAMPUS
MA
05
—
2078767
—
MA
01
—
26373
FALLON
MA
01
—
61250
HARVARD PILGRIM
MA
01
—
701827
TUFTS
MA
05
—
9751530
—
MA
01
—
999969
NETWORK HEALTH
MA
01
—
M18983
BLUE CROSS
MA
01
—
N01922
BLUE CROSS
MA
Enumeration date
05/15/2007
Last updated
11/02/2020
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