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General NPI Number Information
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NPI Number | 1043796790
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Entity Type | Individual
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Provider Name | GEORGIOS MIHALOPULOS MD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 100 GRAND ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-2016
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Country | US
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Telephone | 860-224-5011
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Fax | 203-573-7031
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Provider Business Mailing Address
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Address Line | 64 ROBBINS ST
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City | WATERBURY
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State | CT
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Zip | 06708-2600
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Country | US
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Telephone | 203-573-7257
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Fax | 203-573-6073
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 78952
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License Number State | CT
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