Provider Demographics
NPI:1740289230
Name:POPOV, DIMTCHO V (MD)
Entity type:Individual
Prefix:DR
First Name:DIMTCHO
Middle Name:V
Last Name:POPOV
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3368 HIGHWAY 280
Mailing Address - Street 2:SUITE G-10
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3393
Mailing Address - Country:US
Mailing Address - Phone:256-409-1500
Mailing Address - Fax:256-409-1144
Practice Address - Street 1:711 WOOD ST STE A
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7564
Practice Address - Country:US
Practice Address - Phone:318-323-8847
Practice Address - Fax:318-387-8804
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2025-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA343543207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529917040Medicaid
AL051516344Medicare ID - Type Unspecified
AL529917040Medicaid