Provider Demographics
NPI:1043903297
Name:DEMILD, MARINA ROSE (PA, MPH)
Entity Type:Individual
Prefix:MS
First Name:MARINA
Middle Name:ROSE
Last Name:DEMILD
Suffix:
Gender:F
Credentials:PA, MPH
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Mailing Address - Street 1:19 FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1715
Mailing Address - Country:US
Mailing Address - Phone:508-373-5607
Mailing Address - Fax:
Practice Address - Street 1:19 FOSTER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1715
Practice Address - Country:US
Practice Address - Phone:508-373-5607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant