Dimitre H Dimitrov, MD

Primary specialty

Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X

License

53629 Issued in MI

Practice address

2215 Fuller Rd Dept of
Ann Arbor, MI 48105-2303

Phone

(734) 769-7100

Fax

(734) 845-3235

NPI assigned

Jul 10, 2008

Last updated

Jul 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1770746695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD DEPT OF",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "734-769-7100",
            "fax_number": "734-845-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD DEPT OF",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "734-769-7100",
            "fax_number": "734-845-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITROV",
        "first_name": "DIMITRE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "MI",
            "license": "53629",
            "primary": true
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "MI",
            "license": "446",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAIN LICENSE",
            "identifier": "4301081427",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eleni Vasilios Dimaraki, MD
• Derek E Dimcheff, MD
• Colin Diment
• Anastasia Petro Dimick, M.D.
• Justin Brigham Dimick, M.D.
• Zachary Dimovski
• Yue Ding, MD
• Yujie Ding, MD
• Timothy Anh-Hieu Dinh, MD, PHD
• Maia Dinsmore

• Psychosomatic Medicine Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Psychosomatic Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.