DIMITRIOS KOUDOUMAS (NPI# 1639456767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639456767 |
| Entity Type | Individual |
| Full Name | DIMITRIOS KOUDOUMAS |
| Credential | M.D., PH.D |
| Practice Address |
30 N 1900 E Salt Lake City UT 84132-0002 |
| Practice Telephone | 8015856740 |
| Mailing Telephone | 8015856740 |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2019-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11284193-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 246954 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 75 Francis Street, Brigham and Women's Hospital, Boston, MA 02215 | 6177327678 |
| Street Address |
30 N 1900 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84132-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346238219 | Erin R Harward | Genetic Counselor, MS | 30 N 1900 E, Neurology, University of Utah, Salt Lake City, UT 84132-0002 | 2005-10-13 |
| 1962029611 | Alexia Rae Searle | Nurse Practitioner | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-06-29 |
| 1538783055 | Melinda Orr | Nurse Practitioner | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-06-01 |
| 1588286579 | Peter Joel Christiansen | Physician Assistant | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-05-12 |
| 1700415940 | Michael Zou | Student in an Organized Health Care Education/Training Program | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-04-08 |
| 1356970933 | Nathan Davidson | Student in an Organized Health Care Education/Training Program | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-04-05 |
| 1568091478 | Kartemus O'neal Heary | Student in an Organized Health Care Education/Training Program | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-04-02 |
| 1336777432 | Casey Fenger | Student in an Organized Health Care Education/Training Program | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-04-01 |
| 1265060644 | Jeremy Smith | Student in an Organized Health Care Education/Training Program | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-03-31 |
| 1396373718 | Campbell Walter Miller | Student in an Organized Health Care Education/Training Program | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2020-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275162331 | Scott Andrew Rizzi | Student in an Organized Health Care Education/Training Program | 30 North 1900 East Som 4c116, Salt Lake City, UT 84132 | 2020-04-02 |
| 1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
| 1366975914 | Jacob Brandenburg | Anesthesiology | School of Medicine 30 North 1900 East Room 3c444, Salt Lake City, UT 84132 | 2017-04-10 |
| 1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
| 1912350083 | Gmaan Alzhrani | Student in an Organized Health Care Education/Training Program | 175 N. Medical Drive East , Salt Lake City, UT 84132 | 2016-07-13 |
| 1831544600 | Drew Goerke | Occupational Therapist | 50 N Medical Drive, Som Room #1r73, Salt Lake City, UT 84132 | 2016-04-29 |
| 1891179024 | Bong Jik Kim | Student in an Organized Health Care Education/Training Program | 50 North Medical Drive 3c120, Otolaryngology Administration Office, Salt Lake City, UT 84132 | 2015-07-17 |
| 1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
| 1689061822 | Ryan Clark | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E Som 3c127, Salt Lake City, UT 84132 | 2015-04-24 |
| 1649666264 | Kevin Conrad | Anesthesiology | 30 N 1900 E Room 3c444, Salt Lake City, UT 84132 | 2015-04-09 |
| Find all providers in zip 84132 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609319722 | Antigoni Koliopoulou | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E # Som3c127, Salt Lake City, UT 84132-0002 | 2016-11-21 |
| 1689061822 | Ryan Clark | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E Som 3c127, Salt Lake City, UT 84132 | 2015-04-24 |
| 1487994562 | Edwin Clifford Mcgough | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 705 N Pioneer Fork Rd, Salt Lake City, UT 84108-1642 | 2013-02-26 |
| 1659630572 | John David Vossler | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E # 3c127, Salt Lake City, UT 84132-0002 | 2012-05-12 |
| 1407145535 | Utl Solutions, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 369 E 900 S, Suite 279, Salt Lake City, UT 84111-4331 | 2011-03-29 |
| 1003063934 | Clynn Roberts Ford | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2843 Lancaster Dr, Salt Lake City, UT 84108-2535 | 2008-08-21 |
| 1356335970 | J Kent Thorne | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1160 E. 3900 S, #3500, Salt Lake City, UT 84124 | 2005-09-09 |
| 1255795308 | University of Utah Pediatric Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 | 2016-04-05 |
| 1184028995 | University of Utah Adult Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2014-10-22 |
| 1073871042 | Ashley Eleen Morgan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E, Salt Lake City, UT 84132-0002 | 2012-04-27 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84132 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.