Healthcare Provider Details

I. General information

NPI: 1174869234
Provider Name (Legal Business Name): GREGORY PAPPAS MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 N CAPITOL ST NE
WASHINGTON DC
20002-4263
US

IV. Provider business mailing address

899 N CAPITOL ST NE
WASHINGTON DC
20002-4263
US

V. Phone/Fax

Practice location:
  • Phone: 202-821-9697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberMD17464
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: