Individual
KELLY DIMITRIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
525 E MARKET ST, AKRON, OH 44304-1619
(330) 375-3369
(330) 375-3769
Mailing address
PO BOX 1649, AKRON, OH 44309-1649
(330) 864-8900
(330) 869-8924
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35082869
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000031642
ANTHEM
OH
05
—
2456908
—
OH
01
—
341779226002
MED MUTUAL OH 1 OF 3
OH
01
—
341779226003
MED MUTUAL OH 2 OF 3
OH
01
—
341779226006
MED MUTUAL OF OH 3 OF 3
OH
01
—
61641
UNITED HEALTCARE
OH
Enumeration date
05/26/2006
Last updated
07/08/2007
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