Provider Demographics
NPI:1548798093
Name:NASIOUDIS, DIMITRIOS (MD)
Entity Type:Individual
Prefix:
First Name:DIMITRIOS
Middle Name:
Last Name:NASIOUDIS
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 1:3400 SPRUCE STREET, 1 WEST GATES,
Mailing Address - Street 2:HELLEN O. DICKENS CENTER FOR WOMEN'S HEALTH
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE STREET, 1 WEST GATES,
Practice Address - Street 2:HELLEN O. DICKENS CENTER FOR WOMEN'S HEALTH
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3123
Practice Address - Country:US
Practice Address - Phone:215-662-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT212686207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology