Dimitri Dermatology

LBN: Em Dimitri Do Pmc
Dimitri Dermatology is an health care organization with primary practice located at 624 Highway 90 , Bay St Louis MS 39520-2715. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Em Dimitri Do Pmc can be contacted via phone (228) 467-5644, or through Drake, Karen Rachel via phone (985) 643-4512.

Contact Information

Primary practice address
624 Highway 90 Bay St Louis MS 39520-2715
Phone: (228) 467-5644
Fax: (228) 467-9961
Website:
Map and Directions
Authorized official contact:
Name: Drake, Karen Rachel
Phone: (985) 643-4512

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 21866 Mississippi
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 14885R Louisiana

Profile Details

NPI number 1285993337
LBN Legal business name Em Dimitri Do Pmc
DBA Doing business as Dimitri Dermatology
Authorized official Drake, Karen Rachel
Entity Organization
Organization subpart 1 No
Enumeration date May 10th, 2012
Last updated May 10th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285993337 NPPES
Mississippi MEDICAID 07454201

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