Individual
DR. MARK A DEMIDOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
233 GEORGE JUNIOR RD, GROVE CITY, PA 16127
(724) 421-3355
(724) 406-0240
Mailing address
233 GEORGE JUNIOR RD, GROVE CITY, PA 16127-4417
(724) 421-3355
(724) 406-0240
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD427222
PA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD427222
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1879793
HIGHMARK PROVIDER #
PA
Enumeration date
10/24/2006
Last updated
09/13/2018
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