Provider Demographics
NPI:1942284377
Name:DEMARIA, ANTHONY P (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:P
Last Name:DEMARIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7033 BURLINGTON PIKE STE 2
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1600
Mailing Address - Country:US
Mailing Address - Phone:859-746-3668
Mailing Address - Fax:859-746-3000
Practice Address - Street 1:7033 BURLINGTON PIKE STE 2
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1600
Practice Address - Country:US
Practice Address - Phone:859-746-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY244128213EP0504X, 213EP1101X, 213ER0200X, 213ES0000X, 213ES0131X, 213ES0103X
KY270213ES0103X
AZ0585213ES0103X
KYKY00270213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP01459301OtherRAILROAD MEDICARE
IN201301300Medicaid
000000926847OtherANTHEM
KY7100106670Medicaid
AZ793233Medicaid
IN258420005Medicare PIN
U96086Medicare UPIN
AZ793233Medicaid