Provider Demographics
NPI:1376386474
Name:WINTERS, DEMARRIS E
Entity type:Individual
Prefix:
First Name:DEMARRIS
Middle Name:E
Last Name:WINTERS
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 1:3569 INGLESIDE RD # UP
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5001
Mailing Address - Country:US
Mailing Address - Phone:216-849-5208
Mailing Address - Fax:
Practice Address - Street 1:3569 INGLESIDE RD # UP
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5001
Practice Address - Country:US
Practice Address - Phone:216-849-5208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)