Provider Demographics
NPI:1003628678
Name:PLUMMER, DEMETRIUS D
Entity type:Individual
Prefix:
First Name:DEMETRIUS
Middle Name:D
Last Name:PLUMMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 GAINESVILLE ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-3235
Mailing Address - Country:US
Mailing Address - Phone:202-704-1696
Mailing Address - Fax:
Practice Address - Street 1:4906 JUST ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-4871
Practice Address - Country:US
Practice Address - Phone:202-704-1696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant