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General NPI Number Information
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NPI Number | 1275526014
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Entity Type | Individual
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Provider Name | ERIC M DEMUN MD
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Gender | Male
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 12/17/2009
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Provider Practice Location Address
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Address Line | 1740 COOKS HILL RD
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City | CENTRALIA
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State | WA
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Zip | 98531-9071
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Country | US
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Telephone | 360-736-7623
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Fax | 360-736-4074
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Provider Business Mailing Address
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Address Line | 1740 COOKS HILL RD
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City | CENTRALIA
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State | WA
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Zip | 98531-9071
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Country | US
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Telephone | 360-736-7623
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Fax | 360-736-4074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00035158
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License Number State | WA
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