Deborah Anne Demarais, M.D.
Individual provider Active NPI Pediatrics Physician · Andover, MN
NPI 1992767784 · NPPES record last updated Mar 23, 2012
Key facts
- NPI
- 1992767784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 30250 (MN)
- Practice address
- 13819 Hanson Blvd NW
Andover, MN 55304-7608 - Phone
- (763) 572-5710
- Fax
- (763) 862-4490
- NPI assigned
- Apr 5, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30250 | MN | MD | Surgery Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 30250 | MN | Yes |
Addresses
Primary practice location
13819 Hanson Blvd NW
Andover, MN 55304-7608
Mailing address
6401 University Ave NE
Fridley, MN 55432-4341
Phone (763) 572-5710
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4134987 | Other | MN | AETNA |
| 24161 | Other | MN | AMERICA'S PPO |
| 1200395 | Other | MN | MEDICA |
| 674508300 | Medicaid | MN | |
| HP19874 | Other | MN | HEALTHPARTNERS |
| 08F19DE | Other | MN | BCBS OF MN |
| 1000890 | Other | MN | PREFERRED ONE |
| 107287 | Other | MN | UCARE MN |
| 6603947 | Other | MN | MEDICA UC |
Other providers in Andover, MN
- Andria Davis
- Maria Faye Davis
- Brent D Debruyn
- Jocelyn Machelle Dechene
- Jessica Deist
- Raina Demarais
- Don Curtis Deno
- Emma Derubeis
- Megan Dierking
- Alyssa Marie Doberstein
All providers in Andover, MN · Pediatrics Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.