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General NPI Number Information
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NPI Number | 1679558472
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Entity Type | Individual
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Provider Name | STEVEN MICHAEL DANDALIDES M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 1850 W ARLINGTON BLVD
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City | GREENVILLE
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State | NC
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Zip | 27834-5704
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Country | US
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Telephone | 252-413-6260
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Fax |
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Provider Business Mailing Address
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Address Line | 2349 HAVERSHAM CLOSE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-1154
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Country | US
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Telephone | 757-553-2718
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301504154
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 38598
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 01086272A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0101040588
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License Number State | VA
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