Provider Demographics
NPI:1801991708
Name:ESPORAS, DEMOSTHENES CAGBALIN (MD)
Entity type:Individual
Prefix:DR
First Name:DEMOSTHENES
Middle Name:CAGBALIN
Last Name:ESPORAS
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 1:1816 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5057
Mailing Address - Country:US
Mailing Address - Phone:919-775-7146
Mailing Address - Fax:919-774-7922
Practice Address - Street 1:1816 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5057
Practice Address - Country:US
Practice Address - Phone:919-775-7146
Practice Address - Fax:919-774-7922
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19228208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC30852OtherBCBSNC
NC8930852Medicaid
NC30852OtherBCBSNC
NC206163AMedicare ID - Type Unspecified