DIMITRI MISAILIDIS MD NPI 1053356204

NPI Information

NPI: 1053356204
Provider Name: DIMITRI MISAILIDIS, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
300 FOXCROFT AVE
SUITE 202B
MARTINSBURG, WV
ZIP 25401
Phone: (304) 263-4967
Get Directions

Dimitri Misailidis, MD is a diagnostic radiology radiology in Martinsburg, WV with 45 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Dimitri Misailidis, MD NPI is 1053356204. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

300 FOXCROFT AVE
SUITE 202B
MARTINSBURG, WV
ZIP 25401-341
Phone: (304) 263-4967
Fax: (304) 267-5461

The NPI 1053356204 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/19/2006 and was last updated on 2/1/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	15875	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000848955	OTHER	WEST VIRGINIA	WV BCBS
2	0118129000	MEDICAID	WEST VIRGINIA
3	E07400	MEDICARE UPIN
4	535851500	MEDICAID	MARYLAND
5	MI0646561	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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