Provider Demographics
NPI:1821142191
Name:LEMOS, DIEGO F (MD)
Entity Type:Individual
Prefix:
First Name:DIEGO
Middle Name:F
Last Name:LEMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVE
Mailing Address - Street 2:FAHC-MCHV CAMPUS PATRICK 1 ROOM 117
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-5647
Mailing Address - Fax:802-847-4822
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:FAHC-MCHV CAMPUS PATRICK 1 ROOM 117
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-5647
Practice Address - Fax:802-847-4822
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042-00118282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology