Individual
DR. DEMETRA MCILWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 DOAT ST, BUFFALO, NY 14211-1612
(716) 892-2775
(716) 597-0554
Mailing address
21 DOAT ST, BUFFALO, NY 14211-1612
(716) 892-2775
(716) 597-0554
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
319236
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2019
Last updated
12/16/2022
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