Provider Demographics
NPI:1033198247
Name:ELIOPOULOS, DINA A (MD)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:A
Last Name:ELIOPOULOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9 NORTH RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2755
Mailing Address - Country:US
Mailing Address - Phone:978-275-9440
Mailing Address - Fax:978-275-9470
Practice Address - Street 1:9 NORTH RD
Practice Address - Street 2:SUITE 202
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2755
Practice Address - Country:US
Practice Address - Phone:978-275-9440
Practice Address - Fax:978-275-9470
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2012-04-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA203898208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0123331Medicaid
MA0123331Medicaid
MAA31415Medicare ID - Type Unspecified