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Individual

DR. PETER T DEMOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
125 LIBERTY ST, STE 403, SPRINGFIELD, MA 01103-1109
(413) 739-6611
Mailing address
125 LIBERTY ST, STE 403, SPRINGFIELD, MA 01103-1109
(413) 739-6611

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
58416
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11753
HNE PROVIDER NUMBER
MA
01
725076
TUFTS PROVIDER NUMBER
MA
01
J06761
PROVIDER NUMBER
MA
Enumeration date
07/22/2005
Last updated
12/25/2021
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