Dimitriades, Dimitrios J

Dimitriades, Dimitrios J is an individual health care provider with primary practice located at 394 Courthouse Rd Suite A, Gulfport MS 39507-1865. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dimitriades, Dimitrios J can be contacted via phone (228) 896-4417.

Contact Information

Primary practice address
394 Courthouse Rd Suite A Gulfport MS 39507-1865
Phone: (228) 896-4417
Fax: (228) 604-0121
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 16024 Mississippi

Profile Details

NPI number 1851327522
LBN Legal business name Dimitriades, Dimitrios J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2006
Last updated Jul 10th, 2014 - about 11 years ago

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 1851327522 NPPES
Mississippi MEDICAID 00119666
Mississippi Other 5057532
Mississippi Other 080119197

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