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Individual

DR. DIMITRY A. FOMIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2708 RIFE MEDICAL LN, SUITE 200, ROGERS, AR 72758-1452
(479) 338-3720
(479) 338-3749
Mailing address
2708 RIFE MEDICAL LN, SUITE 200, ROGERS, AR 72758-1452
(479) 338-3720
(479) 338-3749

Taxonomy

Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
E5557
AR
2084N0400X
Neurology Physician
E5557
AR

Other

Enumeration date
11/21/2005
Last updated
10/31/2013
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