Provider Demographics
NPI:1710972864
Name:ISKOS, DEMOSTHENES N (MD)
Entity Type:Individual
Prefix:
First Name:DEMOSTHENES
Middle Name:N
Last Name:ISKOS
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 1:6405 FRANCE AVE S
Mailing Address - Street 2:SUITE W200
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2163
Mailing Address - Country:US
Mailing Address - Phone:952-915-2454
Mailing Address - Fax:
Practice Address - Street 1:6405 FRANCE AVE S
Practice Address - Street 2:SUITE W200
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2163
Practice Address - Country:US
Practice Address - Phone:952-915-2454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT185113-1205207RC0000X, 207RC0001X
MN41933207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1477643179OtherGROUP NPI
UT005765603Medicare PIN
UT1477643179OtherGROUP NPI
UT005516303Medicare PIN