Provider Demographics
NPI:1821143629
Name:YANNOPOULOS, DEMETRI (MD)
Entity Type:Individual
Prefix:
First Name:DEMETRI
Middle Name:
Last Name:YANNOPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DEMETRIS
Other - Middle Name:
Other - Last Name:YANNOPOULOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MINNEAPOLIS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-625-4465
Mailing Address - Fax:612-626-4411
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:MINNEAPOLIS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:612-625-4465
Practice Address - Fax:612-626-4411
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN17516207RC0000X
MN47299207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease