Provider Demographics
NPI:1366035040
Name:DEMITER, SKYLER (PA-C)
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:
Last Name:DEMITER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 BEALL AVE STE 3A
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2342
Mailing Address - Country:US
Mailing Address - Phone:330-202-5700
Mailing Address - Fax:330-202-5701
Practice Address - Street 1:1761 BEALL AVE STE 3A
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2342
Practice Address - Country:US
Practice Address - Phone:330-202-5700
Practice Address - Fax:330-202-5701
Is Sole Proprietor?:No
Enumeration Date:2021-02-14
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006998RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant