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General NPI Number Information
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NPI Number | 1407194194
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Entity Type | Individual
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Provider Name | GEORGIOS CHRISTODOULIDIS
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Gender | Male
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | KIRIAKOU HAPESHI 17
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City | LIMASSOL
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State | ZAKAKI
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Zip | 003046
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Country | CY
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Telephone | 347-320-5302
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Fax |
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Provider Business Mailing Address
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Address Line | KIRIAKOU HAPESHI 17
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City | LIMASSOL
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State | ZAKAKI
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Zip | 003046
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Country | CY
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD-44895
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD-44895
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License Number State | IA
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