Mysh, Dmitry
Mysh, Dmitry is an individual health care provider with primary practice located at 16410 Healthpark Commons Dr , Fort Myers FL 33908-9621. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Mysh, Dmitry can be contacted via phone (239) 343-6202.Contact Information
Primary practice address
16410 Healthpark Commons Dr
Fort Myers FL 33908-9621
Phone: (239) 343-6202
Fax: (239) 437-8537
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 25MA065097 | New Jersey |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 51971 | Kentucky |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | ME142694 | Florida |
Profile Details
| NPI number | 1033105903 |
|---|---|
| LBN Legal business name | Mysh, Dmitry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2005 |
| Last updated | Mar 30th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033105903 | NPPES |
| New Jersey | MEDICAID | 8503206 | |
| New Jersey | MEDICAID | 104397900 |
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