Provider Demographics
NPI:1558380576
Name:GOLFINOPOULOS, DIMITRI (DO)
Entity Type:Individual
Prefix:DR
First Name:DIMITRI
Middle Name:
Last Name:GOLFINOPOULOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E RED BRIDGE RD STE 207
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4030
Mailing Address - Country:US
Mailing Address - Phone:913-681-2398
Mailing Address - Fax:913-681-2416
Practice Address - Street 1:400 E RED BRIDGE RD STE 207
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4030
Practice Address - Country:US
Practice Address - Phone:913-681-2398
Practice Address - Fax:913-681-2416
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100796207R00000X
KS05-28058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200462170BOtherKMAP MISSOURI SIDE
KS1317379OtherUHC
KS22310017OtherBCBSKC
KS7680021OtherCIGNA
MOP00076982OtherMEDICARE RR
KS1558380576OtherUNICARE
KS200462170AMedicaid
MO248592636Medicaid
MOP928913OtherMEDICARE
KSP928913AOtherMEDICARE
MO686848OtherHEALTHLINK
KS0005383087OtherAETNA
KS187170OtherCOVENTRY
MO686848OtherHEALTHLINK