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NPI Code Detail

MEDICARE: DR. DEMETRIOS JOHN KARAMICHOS MD

MEDICARE:  DR. DEMETRIOS JOHN KARAMICHOS  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1202K00000XPhlebology Physician36093881IL
2207Q00000XFamily Medicine Physician01064242AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00721116OTHERILMEDICARE RAILROAD
3P00468376OTHERINMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376535146
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEMETRIOS JOHN KARAMICHOS MD
Provider Business Mailing Address
First Line : 931 RIDGE RD STE C
Second Line :
City : MUNSTER
State : IN
Zip : 46321-1756
Country : US
Telephone Number : 219-595-3095
Fax Number : 219-881-8776
Provider Business Practice Location Address
First Line : 931 RIDGE RD STE C
Second Line :
City : MUNSTER
State : IN
Zip : 46321-1756
Country : US
Telephone Number : 219-595-3095
Fax Number : 219-881-8776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 06/16/2020

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Directions to “ DR. DEMETRIOS JOHN KARAMICHOS MD” Practice Location

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