Demitra Mantzopoulos, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302414867 Issued in MI

Practice address

43900 Garfield Rd Ste 102
Clinton TWP, MI 48038-1137

Phone

(586) 646-2323

NPI assigned

Mar 20, 2023

Last updated

Mar 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1790487130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4829 MANSFIELD AVE APT 3",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731343",
            "telephone_number": "248-410-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD STE 102",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381137",
            "telephone_number": "586-646-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTZOPOULOS",
        "first_name": "DEMITRA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302414867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffanee Mangay-Ayam, NCTM
• Carolin Mann-Bomar, MS, TLLP
• Manouchehr Nikpour MD PC
• Brigitte Elizabeth Manquen, RDN
• Yusra Mansour
• Reveen Maqdasy, MD
• Latoya Marble
• Julie Margitish
• Marie Pitko
• Michael Marion

• Pharmacist in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.