Individual
CHARLES L. DEMARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
340 RIDGE ROAD, SUITE 1, NEWTON FALLS, OH 44444
(330) 872-0330
(330) 872-7664
Mailing address
340 RIDGE ROAD, SUITE 1, NEWTON FALLS, OH 44444
(330) 872-0330
(330) 872-7664
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.050888
OH
207Q00000X
Family Medicine Physician
35050888D
OH
207V00000X
Obstetrics & Gynecology Physician
35050888
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000171147
UHC
OH
01
—
000000757512
ANTHEM
OH
01
—
000000757533
ANTHEM
OH
01
—
000000757681
ANTHEM
OH
01
—
000000757696
ANTHEM
OH
05
—
0564241
—
OH
01
—
341609341059
CARESOURCE
OH
01
—
C02792
UPIN
OH
Enumeration date
08/11/2005
Last updated
08/14/2013
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