Individual
DR. DIMITRIOS JOHN FOTIADIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PYSICIAN SURGEON
Contact information
Practice address
337 GROVE STR, CLIFTON, NJ 07013
(973) 779-3787
(973) 778-6433
Mailing address
337 GROVE STR, CLIFTON, NJ 07013
(973) 778-6433
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA01891100
NJ
2086S0129X
Vascular Surgery Physician
25MA01891100
NJ
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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