Provider Demographics
NPI:1508222944
Name:KAMAITIS, DINAS
Entity Type:Individual
Prefix:
First Name:DINAS
Middle Name:
Last Name:KAMAITIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14560 E 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-1531
Mailing Address - Country:US
Mailing Address - Phone:586-246-8876
Mailing Address - Fax:
Practice Address - Street 1:14560 E 10 MILE
Practice Address - Street 2:13993 10 MILE
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089
Practice Address - Country:US
Practice Address - Phone:586-246-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIK 532 143 014 714343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)