Provider Demographics
NPI:1588631964
Name:DEMAC, ALEX RALPH (MD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:RALPH
Last Name:DEMAC
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:530 MIDDLEBURY RD STE 202B
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2557
Mailing Address - Country:US
Mailing Address - Phone:203-758-1817
Mailing Address - Fax:203-758-1817
Practice Address - Street 1:530 MIDDLEBURY RD STE 202B
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2557
Practice Address - Country:US
Practice Address - Phone:203-758-1817
Practice Address - Fax:203-758-1817
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2017-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0316812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTF83938Medicare UPIN