Provider Demographics
NPI:1407310253
Name:GRAU, DEMIAN EMIL (MD)
Entity Type:Individual
Prefix:DR
First Name:DEMIAN
Middle Name:EMIL
Last Name:GRAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 CALLE 9 SE
Mailing Address - Street 2:REPT METROPOLITANO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-690-8895
Mailing Address - Fax:
Practice Address - Street 1:HOSP FEDERICO TRILLA
Practice Address - Street 2:AVE 65 DE INFANTERIA KM 8.3
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-757-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16297-I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice