Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | C20004216 | DE |
NPI | 1013916766 |
---|---|
Provider Name | Dr. Dimitrios M Zerefos |
First Address | Wilmington, DE 19808 |
Second Address | Wilmington, DE 19808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F91281 | (02) |