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NPI Code Detail

MEDICARE: JOHN MICHAEL PANOPOULOS D.O.

MEDICARE: JOHN MICHAEL PANOPOULOS D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistNH10491NH
2207L00000XAnesthesiology PhysicianNH10491NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356342653
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MICHAEL PANOPOULOS D.O.
Provider Business Mailing Address
First Line : PO BOX 845343
Second Line : PORTSMOUTH ANESTHESIA ASSOCIATES
City : BOSTON
State : MA
Zip : 02284-5343
Country : US
Telephone Number : 800-720-1664
Fax Number : 207-753-2020
Provider Business Practice Location Address
First Line : 333 BORTHWICK AVENUE
Second Line : PORTSMOUTH ANESTHESIA ASSOCIATES
City : PORTSMOUTH
State : NH
Zip : 03801-7128
Country : US
Telephone Number : 603-749-0043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 08/01/2008

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