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General NPI Number Information
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NPI Number | 1295663649
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Entity Type | Individual
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Provider Name | THEODORE DIMITROV MD
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Gender | Male
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 520 W 10TH AVE
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City | COLUMBUS
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State | OH
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Zip | 43210-1328
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Country | US
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Telephone | 614-293-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 BRANDYWINE DR
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City | COLUMBUS
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State | OH
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Zip | 43220-4422
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Country | US
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Telephone | 614-572-6303
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 57.260381
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License Number State | OH
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