Provider Demographics
NPI:1245695808
Name:DEMAREE, DAX (DO)
Entity type:Individual
Prefix:
First Name:DAX
Middle Name:
Last Name:DEMAREE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 BLUESTEM BLVD, STE F
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720
Mailing Address - Country:US
Mailing Address - Phone:715-575-5800
Mailing Address - Fax:
Practice Address - Street 1:1451 BLUESTEM BLVD, STE F
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-7172
Practice Address - Country:US
Practice Address - Phone:715-575-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI73809-21208600000X
MN71091208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery