Healthcare Provider Details

I. General information

NPI: 1710928148
Provider Name (Legal Business Name): JAMES C PAPPAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8414 NAAB RD
INDIANAPOLIS IN
46260-1972
US

IV. Provider business mailing address

8414 NAAB RD
INDIANAPOLIS IN
46260-1972
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number01041240
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: