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General NPI Number Information
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NPI Number | 1871574194
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Entity Type | Individual
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Provider Name | JOHN MATTHEW DIMURO DO
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Gender | Male
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 11/01/2018
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Provider Practice Location Address
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Address Line | 1151 S HIGHWAY 160
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City | PAHRUMP
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State | NV
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Zip | 89048
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Country | US
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Telephone | 775-727-8090
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Fax | 775-537-2090
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Provider Business Mailing Address
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Address Line | 1151 S HIGHWAY 160
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City | PAHRUMP
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State | NV
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Zip | 89048-4700
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Country | US
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Telephone | 775-727-8090
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Fax | 775-537-2090
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 43525
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | DO1392
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 46575
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License Number State | CT
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