Provider Demographics
NPI:1417243270
Name:DEMETER, BRADLEY LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:LOUIS
Last Name:DEMETER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:85 HERRICK ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1790
Mailing Address - Country:US
Mailing Address - Phone:978-922-3000
Mailing Address - Fax:978-524-6028
Practice Address - Street 1:85 HERRICK ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1777
Practice Address - Country:US
Practice Address - Phone:978-922-3000
Practice Address - Fax:978-524-6028
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA258161207P00000X
IN01072493A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine