MEDICARE: KALLIOPE VARAKLIS MD

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
1	207V00000X	Obstetrics & Gynecology Physician	MD16598	ME

General Provider Information

NPI Number	:	1518082577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALLIOPE VARAKLIS MD

Provider Business Mailing Address
First Line	:	22 BRAMHALL ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04102-3134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	39 WALLACE AVE
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-6143
Country	:	US
Telephone Number	:	207-761-0650
Fax Number	:	207-761-8198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	02/06/2013

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