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General NPI Number Information
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NPI Number | 1205832391
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Entity Type | Individual
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Provider Name | CHRIS C. PANAGOULIAS DPM
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 3 WATER ST SUITE 101
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City | NASHUA
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State | NH
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Zip | 03060-3314
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Country | US
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Telephone | 603-883-1321
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Fax | 603-883-1373
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Provider Business Mailing Address
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Address Line | 17 GRANT LN
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City | OGUNQUIT
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State | ME
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Zip | 03907-3647
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Country | US
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Telephone | 603-883-1321
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Fax | 603-883-1373
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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 | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | NH123
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License Number State | NH
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