Provider Demographics
NPI:1154505972
Name:MAGIASIS, DIMITRIOS JIMMY (ND)
Entity Type:Individual
Prefix:DR
First Name:DIMITRIOS
Middle Name:JIMMY
Last Name:MAGIASIS
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HUT TER
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-9733
Mailing Address - Country:US
Mailing Address - Phone:828-407-6177
Mailing Address - Fax:
Practice Address - Street 1:8 HUT TER
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-9733
Practice Address - Country:US
Practice Address - Phone:828-407-6177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60199408175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath