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NPI Code Detail

MEDICARE: DR. GEORGE WILLIAM DEMUTH MD

MEDICARE: DR. GEORGE WILLIAM DEMUTH MD
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
12084P0800XPsychiatry Physician18765AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
251099726OTHERALBLUE CROSS OF ALABAMA

General Provider Information

NPI Number : 1912994310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE WILLIAM DEMUTH MD
Provider Business Mailing Address
First Line : 1040 LONGFIELD CT
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-8055
Country : US
Telephone Number : 334-288-9009
Fax Number : 334-288-9497
Provider Business Practice Location Address
First Line : 1040 LONGFIELD CT
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-8055
Country : US
Telephone Number : 334-288-9009
Fax Number : 334-288-9497
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 05/03/2013

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Directions to “ DR. GEORGE WILLIAM DEMUTH MD” Practice Location

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