MEDICARE: MR. JOHN JAMES DEMARCHI APA-C,MPA-

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	363A00000X	Physician Assistant	1028492	GA

General Provider Information

NPI Number	:	1598764094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN JAMES DEMARCHI APA-C,MPA-

Provider Business Mailing Address
First Line	:	529B WINANS RD
Second Line	:
City	:	WEST POINT
State	:	NY
Zip	:	10996-1216
Country	:	US
Telephone Number	:	845-446-8836
Fax Number	:

Provider Business Practice Location Address
First Line	:	529B WINANS RD
Second Line	:
City	:	WEST POINT
State	:	NY
Zip	:	10996-1216
Country	:	US
Telephone Number	:	845-446-8836
Fax Number	:

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/08/2007

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