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DIMITRI KUZNETSOV M.D. PLLC NPI 1710184494


NPI Information

NPI: 1710184494
Provider Name: DIMITRI KUZNETSOV, M.D. PLLC
Classification: Urology - 2088P0231X
Entity Type: Organization

Specialization: Pediatric Urology

Address:
1274 7TH ST STE B
PORT TOWNSEND, WA
ZIP 98368
Phone: (360) 385-2905
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DIMITRI KUZNETSOV, M.D. PLLC is a pediatric urology urology in Port Townsend, WA. The provider is surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). DIMITRI KUZNETSOV, M.D. PLLC NPI is 1710184494. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1274 7TH ST STE B
PORT TOWNSEND, WA
ZIP 98368-404
Phone: (360) 385-2905

The provider's authorized official is Mary E. Keyes .
The authorized official title is Clinic Manager and has the following contact phone number (360) 385-2905.

The enumeration date for this NPI number is 6/27/2007 and was last updated on 11/28/2007.


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
12088P0231XUrologyPediatric UrologyYes

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
1G8851110MEDICARE PINWASHINGTON
21120955MEDICAIDWASHINGTON

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: 5/5/2024

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