Provider Demographics
NPI:1821083916
Name:DEMING, IRA MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:MICHAEL
Last Name:DEMING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:NONE
Other - Middle Name:NONE
Other - Last Name:NONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:121 CONGRESSIONAL LN
Mailing Address - Street 2:#312
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1542
Mailing Address - Country:US
Mailing Address - Phone:301-816-8681
Mailing Address - Fax:301-816-8684
Practice Address - Street 1:121 CONGRESSIONAL LN
Practice Address - Street 2:#312
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1542
Practice Address - Country:US
Practice Address - Phone:301-816-8681
Practice Address - Fax:301-816-8684
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00914213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4242206OtherAETNA
MD224151OtherMAMSI
MD061908600Medicaid
MD156711OtherBSNCA
MD224151OtherMAMSI