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Contact Information

E. M. DIMITRI, D.O. PMC
2104 GAUSE BLVD W
SUITE A
SLIDELL, LA70460-4130
 Phone: 985-643-4575
 Fax: 985-643-4513
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for E. M. DIMITRI, D.O. PMC

NPI # 1821285974
LBN Legal business name E. M. DIMITRI, D.O. PMC
Authorized official KAREN DRAKE - (GENERAL MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/02/2007
Last updated 01/31/2024 - About 2 years ago
Identifiers
LA License # 14885R
LA Medicaid 2109511
MS Medicaid 07454201
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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