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1992791453

NPI Code Detail

MEDICARE: WILLIAM J DEMOTS MD

MEDICARE: WILLIAM J DEMOTS 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
1	207Q00000X	Family Medicine Physician	4301035215	MI

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
2	03634	OTHER		PARAMOUNT
3	396443925-001	OTHER		MMO
4	4220274	OTHER		AETNA
5	0804641971	OTHER		BCBS MI
6	000000387441	OTHER		ANTHEM
7	113277	OTHER		CARECHOICES/PREFERRED CHO
8	P00254442	OTHER		RRMC
9	E86031	OTHER	MI	BCBS OF MICHIGAN

General Provider Information

NPI Number	:	1992791453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM J DEMOTS MD

Provider Business Mailing Address
First Line	:	777 KIMOLE LN
Second Line	:	SUITE 230
City	:	ADRIAN
State	:	MI
Zip	:	49221-1478
Country	:	US
Telephone Number	:	517-263-5655
Fax Number	:	517-263-8012

Provider Business Practice Location Address
First Line	:	8765 LEWIS AVE
Second Line	:
City	:	TEMPERANCE
State	:	MI
Zip	:	48182-9583
Country	:	US
Telephone Number	:	734-847-3802
Fax Number	:	734-850-0520

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	06/18/2015

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Directions to “ WILLIAM J DEMOTS MD” Practice Location

Language	Start Address	Practice Location

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