Brunette, Georgia Dimos
Brunette, Georgia Dimos is an individual health care provider with primary practice located at 3500 Tower Ave , Superior WI 54880-5335. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Brunette, Georgia Dimos can be contacted via phone (715) 395-5454.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 41637-021 | Wisconsin |
Profile Details
| NPI number | 1043255342 |
|---|---|
| LBN Legal business name | Brunette, Georgia Dimos |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 19th, 2006 |
| Last updated | May 9th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043255342 | NPPES |
| Wisconsin | MEDICAID | 30096700 |
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