Larissa M Dimitrov in Shoreview - Geriatric Medicine
Larissa M Dimitrov - NPI 1386827053
Larissa M Dimitrov is a Geriatric Medicine in Shoreview, Minnesota. Larissa M Dimitrov practices all healthcare services and medical treatments related to Geriatric Medicine. The NPI Number for Larissa M Dimitrov is 1386827053. The last update date is 2023-09-26.
Larissa M Dimitrov's current location address is 4166 Lexington Ave N, Shoreview, Minnesota. You can contact this provider via phone number 6514835461. The mailing address for Larissa M Dimitrov is 4166 Lexington Ave N, Shoreview, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larissa M Dimitrov |
|---|---|
| Address | 4166 Lexington Ave N, Shoreview, Minnesota |
| Phone Number | 6514835461 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1386827053 |
|---|---|
| Provider Enumeration Date | 2007-12-17 |
| Last Updated Date | 2023-09-26 |
Provider Mailing Address Detail
| Address | 4166 Lexington Ave N |
|---|---|
| City | Shoreview |
| State | Minnesota (MN) |
| Post Code | 551266106 |
| Phone Number | 6514835461 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Geriatric Medicine |
|---|---|
| Taxonomy | 207Qg0300X |
| Licence No | 72958 |
|
Definition: A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 01062576A | IN | LICENSE |
Post Comment/ Review Below
What is the Larissa M Dimitrov's unique identification number?
The Larissa M Dimitrov has been assigned the NPI (National Provider Identifier) Number 1386827053 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Larissa M Dimitrov is physically located?
The Larissa M Dimitrov is situated at the following address: 4166 Lexington Ave N, Shoreview, MN 551266106.
What is Larissa M Dimitrov's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Larissa M Dimitrov is Geriatric Medicine, and the taxonomy classification code that categorizes this area of expertise is 207Qg0300X.
On what date did the Centers for Medicare & Medicaid Services assign the 1386827053 to Larissa M Dimitrov?
The Centers for Medicare & Medicaid Services assigned the 1386827053 to Larissa M Dimitrov on 2007-12-17.
When was the information related to Larissa M Dimitrov most recently updated or refreshed?
The details pertaining to the Larissa M Dimitrov, including its address, specialty, and other relevant information, were last updated or refreshed on 2023-09-26.
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