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Individual

KIRK D DIMITRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35.085490
OH
207X00000X
Orthopaedic Surgery Physician
Primary
52604-020
WI
207X00000X
Orthopaedic Surgery Physician
ME100953
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518020429
BCBS
WI
05
207X00000X
WI
01
390806395003
CHAMPUS
WI
Enumeration date
12/19/2006
Last updated
04/21/2026
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