Healthcare Provider Details

I. General information

NPI: 1689015687
Provider Name (Legal Business Name): ALISTAIR ROSS DEMCOE M.D., FRCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 07/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 JACKSON ST REGIONS HOSPITAL-DEPARTMENT OF ORTHOPAEDIC SURGERY
SAINT PAUL MN
55101-2502
US

IV. Provider business mailing address

640 JACKSON ST REGIONS HOSPITAL-DEPARTMENT OF ORTHOPAEDIC SURGERY
SAINT PAUL MN
55101-2502
US

V. Phone/Fax

Practice location:
  • Phone: 902-476-7677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number56302
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: