Davydow, Dimitry Samuel

Davydow, Dimitry Samuel is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychosomatic Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Davydow, Dimitry Samuel can be contacted via phone (352) 265-0301.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-0001
Phone: (352) 265-0301
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychosomatic Medicine 2084P0015X ME165986 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME165986 Florida

Profile Details

NPI number 1619911930
LBN Legal business name Davydow, Dimitry Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Dec 29th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619911930 NPPES
Washington Other 0257115 L&I
Washington MEDICAID 1619911930 L&I

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