Provider Demographics
NPI:1033554647
Name:GARNER, DEMETRIUS O'BRIAN
Entity Type:Individual
Prefix:MR
First Name:DEMETRIUS
Middle Name:O'BRIAN
Last Name:GARNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 LAKESHORE DR
Mailing Address - Street 2:MCWHORTER SCHOOL OF PHARMACY
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35229-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 LAKESHORE DR
Practice Address - Street 2:MCWHORTER SCHOOL OF PHARMACY
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35229-0001
Practice Address - Country:US
Practice Address - Phone:205-726-2011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS10606390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program