MEDICARE: SPYRIDON KANTAS, MD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1356232292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPYRIDON KANTAS, MD, LLC

Provider Business Mailing Address
First Line	:	45 WILLIAM ST
Second Line	:
City	:	ANDOVER
State	:	MA
Zip	:	01810-2547
Country	:	US
Telephone Number	:	978-886-3504
Fax Number	:

Provider Business Practice Location Address
First Line	:	69 PARK ST
Second Line	:
City	:	ANDOVER
State	:	MA
Zip	:	01810-3691
Country	:	US
Telephone Number	:	978-886-3504
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SPYRIDON KANTAS
Credential	:	MD
Telephone Number	:	978-886-3504

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	07/10/2025

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