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Individual

MICHAEL J DEMOTTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1925 PACIFIC AVE, ATLANTIC CITY, NJ 08401-6713
(609) 652-1000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01059078
IN
2084P0800X
Psychiatry Physician
01059078A
IN
2084P0800X
Psychiatry Physician
Primary
D12309700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0965715
NJ
05
200460650
IN
Enumeration date
05/27/2006
Last updated
05/07/2024
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