Healthcare Provider Details

I. General information

NPI: 1336183078
Provider Name (Legal Business Name): JANICE M. DEMARAY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1266 WALTON BLVD
ROCHESTER HILLS MI
48307-6900
US

IV. Provider business mailing address

18161 W 13 MILE RD SUITE A-2
SOUTHFIELD MI
48076
US

V. Phone/Fax

Practice location:
  • Phone: 248-710-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101011130
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: