Individual
AGISILAOS MAKRODIMITRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
210 E UNIVERSITY PKWY, BALTIMORE, MD 21218-2828
(202) 877-9696
Mailing address
1000 RIVER RD, STE 100, CONSHOHOCKEN, PA 19428-2439
(800) 355-3818
(610) 834-2862
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C02281
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970016787
RAILROAD MED
MD
Enumeration date
09/14/2006
Last updated
01/12/2015
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