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General NPI Number Information
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NPI Number | 1093112039
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Entity Type | Organization
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Legal Business Name | EMERGENCY ROOM GROUP LTD
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 2809 DENNY AVE
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City | PASCAGOULA
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State | MS
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Zip | 39581-5301
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Country | US
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Telephone | 228-809-5154
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Fax |
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Provider Business Mailing Address
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Address Line | 298 S YONGE ST
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City | ORMOND BEACH
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State | FL
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Zip | 32174-6264
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Country | US
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Telephone | 386-274-7800
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Fax | 386-274-7801
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Authorized Official
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Title or Position | AUTHOIRZED OFFICIAL
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Name | DR. STEVE DEMETROPOULOS
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Credential |
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Telephone | 386-274-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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