Provider Demographics
NPI:1639148679
Name:DEMEIRA, ELIO D (MD)
Entity Type:Individual
Prefix:
First Name:ELIO
Middle Name:D
Last Name:DEMEIRA
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 1:201 STATE ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16550-0002
Mailing Address - Country:US
Mailing Address - Phone:814-877-5330
Mailing Address - Fax:814-877-5331
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-5330
Practice Address - Fax:814-877-5331
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS18025207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS753068151OtherMS HEALTH PARTNERS
MS300002200OtherUS DEPT OF LABOR
MS753068151OtherMS PHYSICIANS CARE NETWOR
MS05504771Medicaid
MS753068151OtherTRICARE
MSP00015357OtherRR MEDICARE
MS753068151OtherMS PHYSICIANS CARE NETWOR
MS140000159Medicare ID - Type Unspecified
MSE52853Medicare UPIN