Provider Demographics
NPI:1023037579
Name:DINULOS, JAMES G (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:DINULOS
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 1:330 BORTHWICK AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4174
Mailing Address - Country:US
Mailing Address - Phone:603-431-5205
Mailing Address - Fax:603-436-4257
Practice Address - Street 1:330 BORTHWICK AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4174
Practice Address - Country:US
Practice Address - Phone:603-431-5205
Practice Address - Fax:603-436-4257
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10990207N00000X, 207N00000X, 207N00000X
VT042-0010123207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16910Medicare UPIN
VT0RE5721Medicaid
NH30200842Medicaid
NHRE5721Medicare ID - Type Unspecified