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General NPI Number Information
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NPI Number | 1447298583
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Entity Type | Individual
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Provider Name | JAMES P DEMETRIOU MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 19401 E 39TH ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64057-2308
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Country | US
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Telephone | 816-490-4277
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 200
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City | MIAMI
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State | FL
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Zip | 33126-3168
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2025049483
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License Number State | MO
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