Healthcare Provider Details

I. General information

NPI: 1417943515
Provider Name (Legal Business Name): MARIA P PAPOUTSIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 GOOD HOPE RD
ENOLA PA
17025-1233
US

IV. Provider business mailing address

1824 GOOD HOPE RD
ENOLA PA
17025-1233
US

V. Phone/Fax

Practice location:
  • Phone: 717-732-8877
  • Fax: 717-732-9241
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD423565
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: