Individual
DIMITRIOS N MINADAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
495 STATION AVE, SOUTH YARMOUTH, MA 02664-1218
(774) 552-3208
(320) 202-8949
Mailing address
16 JANICE RD, SOUTH YARMOUTH, MA 02664-2935
(320) 291-3184
(320) 291-3184
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1916
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063852085
—
MN
Enumeration date
07/05/2013
Last updated
10/05/2021
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