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General NPI Number Information
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NPI Number | 1114292455
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Entity Type | Individual
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Provider Name | ALEXANDER IAN PAPOLOS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 110 IRVING ST NW
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City | WASHINGTON
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State | DC
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Zip | 20010-3017
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Country | US
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Telephone | 203-247-0475
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 4TH ST APT 808
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City | SAN FRANCISCO
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State | CA
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Zip | 94158-2278
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Country | US
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Telephone | 203-247-0475
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Fax |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD046916
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License Number State | DC
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