Provider Demographics
NPI:1881674315
Name:DEMOS, JOHN E (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:DEMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JACK
Other - Middle Name:E
Other - Last Name:DEMOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2 ALLEGHENY CTR
Mailing Address - Street 2:SUITE 530
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5402
Mailing Address - Country:US
Mailing Address - Phone:412-231-0200
Mailing Address - Fax:412-231-0613
Practice Address - Street 1:2 ALLEGHENY CTR
Practice Address - Street 2:SUITE 530
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5402
Practice Address - Country:US
Practice Address - Phone:412-231-0200
Practice Address - Fax:412-231-0613
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026639EY208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008507400001Medicaid
PA1552235OtherCIGNA
PAC29978OtherHEALTH AMERICA
PA101079OtherUPMC
PAC29978OtherHEALTH AMERICA
PA101078LGFMedicare ID - Type Unspecified