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General NPI Number Information
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NPI Number | 1407310253
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Entity Type | Individual
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Provider Name | DEMIAN EMIL GRAU MD
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Gender | Male
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Dates
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Enumeration Date | 01/25/2019
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | HOSP FEDERICO TRILLA AVE 65 DE INFANTERIA KM 8.3
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City | CAROLINA
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State | PR
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Zip | 00984
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Country | US
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Telephone | 787-757-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 1047 CALLE 9 SE REPT METROPOLITANO
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City | SAN JUAN
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-690-8895
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 24013
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License Number State | PR
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