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Individual

DMITRY MYSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16410 HEALTHPARK COMMONS DR, FORT MYERS, FL 33908-9621
(239) 343-6202
(239) 437-8537
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6202
(239) 437-8537

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
25MA065097
NJ
207RG0100X
Gastroenterology Physician
51971
KY
207RG0100X
Gastroenterology Physician
Primary
ME142694
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104397900
FL
05
8503206
NJ
Enumeration date
09/26/2005
Last updated
03/30/2021
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