Individual
DR. DMITRI PAVLO DMYTRUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
875 GREENLAND RD UNIT C4, PORTSMOUTH, NH 03801-4163
(603) 431-5529
(603) 436-6603
Mailing address
105 CORPORATE DRIVE, PORTSMOUTH, NH 03801
(603) 501-5584
(603) 501-5650
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
14493
NH
208100000X
Physical Medicine & Rehabilitation Physician
229604
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3084211
—
NH
Enumeration date
05/01/2008
Last updated
04/17/2020
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