Individual
DEMETRIOS K. MAVROIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
65 W JIMMIE LEEDS RD, POMONA, NJ 08240-9102
(609) 652-1000
Mailing address
65 W JIMMIE LEEDS RD, POMONA, NJ 08240-9102
(609) 652-1000
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
25IA12362700
NJ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
9145
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018224
—
NV
Enumeration date
01/03/2006
Last updated
10/23/2024
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