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Individual

DR. DAVID ANTHONY DEMANGONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6025 COMMERCE CIR, #2, WILLOUGHBY, OH 44094-9668
(440) 944-1414
(440) 944-1445
Mailing address
6025 COMMERCE CIR, #2, WILLOUGHBY, OH 44094-9668
(440) 944-1414
(440) 944-1445

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
35071438D
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000360726
BLUE CROSS/BLUE SHIELD
OH
01
050049657
RAILROAD MEDICARE
OH
05
2008053
OH
Enumeration date
04/19/2006
Last updated
06/17/2011
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