Healthcare Provider Details

I. General information

NPI: 1306807482
Provider Name (Legal Business Name): NICHOLAS H PAPAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 04/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 WADSWORTH ROAD SUITE J
WADSWORTH OH
44281-4218
US

IV. Provider business mailing address

185 WADSWORTH RD SUITE J
WADSWORTH OH
44281-8330
US

V. Phone/Fax

Practice location:
  • Phone: 330-334-7800
  • Fax: 330-334-3252
Mailing address:
  • Phone: 330-334-7800
  • Fax: 330-334-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35-06-3840
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: