Individual
ROSEN K DIMITROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(952) 967-7977
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
01059563A
IN
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
45659-020
WI
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
73085
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200857100
—
IN
05
—
34550200
—
WI
Enumeration date
11/25/2005
Last updated
08/10/2023
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