Provider Demographics
NPI:1134200801
Name:KARADIMOS, JAMES D (DPM)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:KARADIMOS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 LYMAN ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2628
Mailing Address - Country:US
Mailing Address - Phone:508-836-0200
Mailing Address - Fax:508-836-0282
Practice Address - Street 1:45 LYMAN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2628
Practice Address - Country:US
Practice Address - Phone:508-836-0200
Practice Address - Fax:508-836-0282
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1885213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0362433Medicaid
MAT90694Medicare UPIN
MAY70913Medicare ID - Type Unspecified