MEDICARE: DR. MICHAEL ALEXANDER DEMOS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	19115	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639144975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ALEXANDER DEMOS M.D.

Provider Business Mailing Address
First Line	:	1 MERCADO ST
Second Line	:	STE 130
City	:	DURANGO
State	:	CO
Zip	:	81301-7306
Country	:	US
Telephone Number	:	970-247-1120
Fax Number	:	970-247-1128

Provider Business Practice Location Address
First Line	:	1 MERCADO ST
Second Line	:	STE 130
City	:	DURANGO
State	:	CO
Zip	:	81301-7306
Country	:	US
Telephone Number	:	970-247-1120
Fax Number	:	970-247-1128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	09/20/2016

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