Healthcare Provider Details

I. General information

NPI: 1528325339
Provider Name (Legal Business Name): DR. ARISTOTELIS CHARALAMPOS PAPAYANNIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 KINGS HWY DEPARTMENT OF CARDIOLOGY
SHREVEPORT LA
71103-4228
US

IV. Provider business mailing address

110 IRVING ST NW DEPT OF INTERNAL MEDICINE
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 318-675-5941
  • Fax: 318-675-5686
Mailing address:
  • Phone: 202-877-8278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberU2968
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number310802
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: