MEDICARE: DESPOINA MICHAILIDOU 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
1	207R00000X	Internal Medicine Physician	D84263	MD
2	207RR0500X	Rheumatology Physician	MD60943118	WA
3	207RR0500X	Rheumatology Physician	333109-01	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1891109781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESPOINA MICHAILIDOU MD

Provider Business Mailing Address
First Line	:	1111 WESTCHESTER AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604-3525
Country	:	US
Telephone Number	:	914-229-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 WESTCHESTER AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10604-3525
Country	:	US
Telephone Number	:	914-229-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2014
Last Update Date	:	07/09/2025

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Directions to “ DESPOINA MICHAILIDOU MD” Practice Location

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