Individual
MR. JAMES CHARLES DEMIDOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6674 TIPPECANOE RD STE 1, CANFIELD, OH 44406-9149
(330) 533-8490
(330) 533-8783
Mailing address
6674 TIPPECANOE RD STE 1, CANFIELD, OH 44406-9149
(330) 533-8490
(330) 533-8783
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
34-00-3113D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0449394
—
OH
01
—
080053951
RAILROAD MEDICARE
OH
Enumeration date
12/29/2005
Last updated
05/29/2019
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