Individual
STEPHANIE M DEMKOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1716 HARTFORD ST, LAFAYETTE, IN 47904-2173
(765) 742-1567
(765) 429-6961
Mailing address
1716 HARTFORD ST, LAFAYETTE, IN 47904-2173
(765) 742-1567
(765) 429-6961
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01056874A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200353160
—
IN
Enumeration date
07/11/2006
Last updated
07/08/2007
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