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General NPI Number Information
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NPI Number | 1083111942
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Entity Type | Individual
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Provider Name | DEMITRIOS DEDOUSIS MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE CA-53
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-445-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 9500 EUCLID AVE CA-53
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-445-0099
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | MD480704
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35.152936
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License Number State | OH
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