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NPI Code Detail

MEDICARE: DR. PANAGIOTIS FOURTOUNIS MD

MEDICARE: DR. PANAGIOTIS FOURTOUNIS 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
1174400000XSpecialistMD00044865WA

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 : 1700889748
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PANAGIOTIS FOURTOUNIS MD
Provider Business Mailing Address
First Line : 820 NW 12TH AVE
Second Line : APT 516
City : PORTLAND
State : OR
Zip : 97209-3042
Country : US
Telephone Number : 503-539-8519
Fax Number :
Provider Business Practice Location Address
First Line : 14406 NE 20TH AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98686-1448
Country : US
Telephone Number : 360-418-6001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 02/26/2010

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Directions to “ DR. PANAGIOTIS FOURTOUNIS MD” Practice Location

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