Individual
MYRA DIMITROV DIMITROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2323 S TRUNK RD APT 6, PALMER, AK 99645
(907) 746-6644
Mailing address
2323 S TRUNK RD APT 6, PALMER, AK 99645-5940
(907) 746-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125163
AK
Other
Enumeration date
04/15/2014
Last updated
11/08/2019
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