Healthcare Provider Details

I. General information

NPI: 1467015776
Provider Name (Legal Business Name): SAMANTHA JAYMES DEMARSH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE
AURORA CO
80045-7106
US

IV. Provider business mailing address

8752 E 47TH AVE
DENVER CO
80238-3967
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-6740
  • Fax: 720-777-7227
Mailing address:
  • Phone: 216-280-6604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0068296
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: