Provider Demographics
NPI:1245247873
Name:DEMATOS, PIERRE (MD)
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:
Last Name:DEMATOS
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:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5698
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:80 DOCTORS DR STE 1
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-7289
Practice Address - Country:US
Practice Address - Phone:828-654-0073
Practice Address - Fax:828-681-5036
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800837208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCC695C489Medicare PIN
NC89128Y3Medicaid
NCH40092Medicare UPIN