Provider Demographics
NPI:1558422337
Name:DEMIER, SERGIO G (DO)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:G
Last Name:DEMIER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2403 W WRANGLER BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-1900
Mailing Address - Country:US
Mailing Address - Phone:405-382-4939
Mailing Address - Fax:405-382-4947
Practice Address - Street 1:2403 W WRANGLER BLVD STE A
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-1900
Practice Address - Country:US
Practice Address - Phone:405-382-4939
Practice Address - Fax:405-382-4947
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK3350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G36851Medicare UPIN