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1396065694
AMY M DIMITRIADES
GULFPORT, MS
NPI
1396065694
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS R859046)
Enumeration Date
2010-06-09
Last Update Date
2014-07-10
Business Address
-- AMY M DIMITRIADES NP-C
4540 W RAILROAD ST
GULFPORT, MS 39501-2480
Phone number: 228-867-6062
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Mailing Address
-- AMY M DIMITRIADES NP-C
PO BOX 1810
GULFPORT, MS 39502-1810
Phone number: 228-865-1330
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