Provider Demographics
NPI:1528689510
Name:MAKRIDIS, DIMITRIOS (MD)
Entity type:Individual
Prefix:DR
First Name:DIMITRIOS
Middle Name:
Last Name:MAKRIDIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NIKAIAS 5
Mailing Address - Street 2:
Mailing Address - City:VERIA
Mailing Address - State:IMATHIAS - GREECE
Mailing Address - Zip Code:59132
Mailing Address - Country:GR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NIKAIAS 5
Practice Address - Street 2:
Practice Address - City:VERIA
Practice Address - State:IMATHIAS - GREECE
Practice Address - Zip Code:59132
Practice Address - Country:GR
Practice Address - Phone:697-635-2484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ46820012014405300000X
MO2020032479207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No405300000XOther Service ProvidersPrevention Professional