Individual
DMITRIY R SINTSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 MARY STREET, EVANSVILLE, IN 47747-2195
(812) 450-2240
(812) 450-2710
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8085
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01067281A
IN
207L00000X
Anesthesiology Physician
Primary
61870
MN
207L00000X
Anesthesiology Physician
9526
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000639273
ANTHEM PROVIDER NUMBER
IN
05
—
200974210
—
IN
Enumeration date
09/20/2006
Last updated
02/13/2020
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