MEDICARE: VIOLET F DEMAO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1744P3200X	Prosthetics Case Management	117915	MD

General Provider Information

NPI Number	:	1144426362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIOLET F DEMAO

Provider Business Mailing Address
First Line	:	4337 NORTHVIEW DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2601
Country	:	US
Telephone Number	:	301-390-3930
Fax Number	:	301-390-3937

Provider Business Practice Location Address
First Line	:	4337 NORTHVIEW DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-2601
Country	:	US
Telephone Number	:	301-390-3930
Fax Number	:	301-390-3937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	07/08/2007

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