Individual
DIMITRI BOREISHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1111 6TH AVE, DES MOINES, IA 50314-2613
(515) 643-2682
(515) 643-5802
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 643-2682
(515) 643-5802
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R-11655
IA
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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