Provider Demographics
NPI:1417515354
Name:STUART V DEMIRS MD LLC
Entity Type:Organization
Organization Name:STUART V DEMIRS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMIRS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-364-0770
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02813-0901
Mailing Address - Country:US
Mailing Address - Phone:401-364-0770
Mailing Address - Fax:401-364-7694
Practice Address - Street 1:4099 OLD POST RD
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02813-2553
Practice Address - Country:US
Practice Address - Phone:401-364-0770
Practice Address - Fax:401-364-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty