Provider Demographics
NPI:1104972702
Name:DEMETER, STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:DEMETER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 WEST ARBOR DR
Mailing Address - Street 2:MAIL CODE - 0624
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-0624
Mailing Address - Country:US
Mailing Address - Phone:619-543-1899
Mailing Address - Fax:619-543-3183
Practice Address - Street 1:200 WEST ARBOR DR
Practice Address - Street 2:MAIL CODE - 0624
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-0624
Practice Address - Country:US
Practice Address - Phone:619-543-1899
Practice Address - Fax:619-543-3183
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG818792084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B82197Medicare UPIN