Individual
DIMITRA THEODOROPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., FACS
Contact information
Practice address
310 E SHORE RD, SUITE 203, GREAT NECK, NY 11023-2410
(516) 482-8657
(516) 829-0002
Mailing address
310 E SHORE RD, SUITE 203, GREAT NECK, NY 11023-2410
(516) 482-8657
(516) 829-0002
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
251938
NY
208600000X
Surgery Physician
4301081475
MI
208C00000X
Colon & Rectal Surgery Physician
251938
NY
208C00000X
Colon & Rectal Surgery Physician
4301081475
MI
Other
Enumeration date
09/05/2006
Last updated
04/01/2009
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