Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 8782 | NV |
NPI | 1063457737 |
---|---|
Provider Name | Dimitrios T Diamandidis |
First Address | Las Vegas, NV 89193-8978 |
Second Address | Las Vegas, NV 89128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 21/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002018648 | (05) | NV |
0020-18648 | (05) | NV |
F21467 | (02) | |
F21467 | (02) | NV |
PENDING | (05) | NV |