Healthcare Provider Details

I. General information

NPI: 1386819969
Provider Name (Legal Business Name): IOANNIS KARAKIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST # 739-L MASSACHUSETTS GENERAL HOSPITAL, DEPARTMENT OF NEUROLOGY
BOSTON MA
02114-2621
US

IV. Provider business mailing address

49 JESSE HILL JR DR SE OFC 335
ATLANTA GA
30303-3049
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-3311
  • Fax:
Mailing address:
  • Phone: 404-616-4013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number229384
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number67662
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: