Dba Robert Demotto Jr

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

DBA ROBERT DEMOTTO JR

Practice address

112 Woody Simmons Drive
Mill Creek, WV 26280-2628

Phone

(304) 446-3673

NPI assigned

Nov 8, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Demotto Jr., MD

Title

Owner

Phone

(304) 446-3673

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1386468296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "26241",
            "telephone_number": "304-446-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WOODY SIMMONS DRIVE",
            "city": "MILL CREEK",
            "state": "WV",
            "postal_code": "262802628",
            "telephone_number": "304-446-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DBA ROBERT DEMOTTO JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "DEMOTTO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-446-3673",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mill Creek, WV
• Voluntary or Charitable Agency in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.