Individual
DR. DENNIS M DIMITRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
295 LINCOLN ST, SUITE 204, WORCESTER, MA 01605-3639
(508) 757-5520
(508) 797-0360
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46145
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0172308
—
MA
01
—
4116
FALLEN COMMUNITY HEALTH
—
01
—
705233
TUFTS HEALTH PLAN
—
01
—
7150
HARVARD PILGRIM HEALTH
—
Enumeration date
12/27/2005
Last updated
12/15/2020
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