Healthcare Provider Details
I. General information
NPI: 1124967773
Provider Name (Legal Business Name): SPYRIDON PAPADIMATOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/27/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 WASHINGTON ST
BOSTON MA
02111
US
IV. Provider business mailing address
115 SAINT BOTOLPH STREET
BOSTON MA
02115
US
V. Phone/Fax
- Phone: 617-636-5000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 3020822 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: