Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. DIMITRY A. FOMIN, MD
ActiveDR. DIMITRY A. FOMIN, MD is a Sports Medicine (IM) healthcare provider located in ROGERS, Arkansas. NPI 1831171263 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (IM) · ROGERS, AR
Registration Details
- NPI Number
- 1831171263
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 21, 2005 (20.767574801859 yrs)
- Last Updated
- Oct 31, 2013
- Licenses
-
E5557 (AR)E5557 (AR)
Practice Information
- Address
-
2708 RIFE MEDICAL LNSUITE 200ROGERS, AR, 727581452Browse AR providers · Browse ZIP 72758
- Phone
- 4793383720
- Fax
- 4793383749
- Primary Specialty
-
Sports Medicine (IM)
207RS0012X
- Additional Specialty
- Sports Medicine (IM)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.