Provider Demographics
NPI:1144288481
Name:DEMARCO, JAMES KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEVIN
Last Name:DEMARCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9805 BRIXTON LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1523
Mailing Address - Country:US
Mailing Address - Phone:517-643-0677
Mailing Address - Fax:
Practice Address - Street 1:4494 N PALMER RD DEPT OF RADIOLOGY BLDG 9, ROOM 1799
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-7037
Practice Address - Country:US
Practice Address - Phone:301-295-4428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010847512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1144288481Medicaid
MI4647616Medicaid
MI1144288481Medicaid
MI4647616Medicaid