Provider Demographics
NPI:1063577005
Name:AGRIANTONIS, DEMETRIOS J (MD)
Entity type:Individual
Prefix:
First Name:DEMETRIOS
Middle Name:J
Last Name:AGRIANTONIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4755 OGLETOWN STANTON ROAD
Mailing Address - Street 2:SUITE 1E20
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718
Mailing Address - Country:US
Mailing Address - Phone:302-733-5625
Mailing Address - Fax:302-733-5665
Practice Address - Street 1:4755 OGLETOWN STANTON ROAD
Practice Address - Street 2:SUITE 1E20
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718
Practice Address - Country:US
Practice Address - Phone:302-733-5625
Practice Address - Fax:302-733-5665
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2023-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI1899207U00000X
DEC100101952085R0202X
DEC1-00101952085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology