Individual
DIMITRIS GEROTHANASSIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 891-7000
Mailing address
3115 ALAMEDA ST APT 23, MEDFORD, OR 97504-9677
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
226334
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2134489
—
MA
Enumeration date
08/22/2006
Last updated
04/05/2022
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