Dimitrios Moustakas, DPM
Podiatrist in Smyrna, DE. Individual provider (NPI-1).
NPI number1982131173
StatusActive
Last updated in NPPESOct 28, 2024
Details
- NPI
- 1982131173
- Entity type
- Individual (NPI-1)
- Name
- Dimitrios Moustakas
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 18, 2017
- Certification date
- Oct 28, 2024
- Last updated
- Oct 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213E00000X | Podiatrist | E1-0000263 | DE | Yes |
Practice location
315 N Carter RdSmyrna, DE 19977-1282
Phone 302-730-4366 · Fax 302-730-0231
Mailing address
640 S. State StMail Code 3055
Dover, DE 19901-3530
Phone 302-730-4366 · Fax 302-730-0231
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