Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD19775 | DC |
NPI | 1114938081 |
---|---|
Provider Name | Dr. Gregory Dean Trachiotis |
First Address | Washington, DC 20037-3201 |
Second Address | Washington, DC 20037-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F00370 | (02) |