Provider Demographics
NPI:1033198809
Name:PAPPAS, STEPHEN GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GEORGE
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4725
Mailing Address - Country:US
Mailing Address - Phone:912-264-9999
Mailing Address - Fax:912-264-8099
Practice Address - Street 1:2600 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4725
Practice Address - Country:US
Practice Address - Phone:912-264-9999
Practice Address - Fax:912-264-8099
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029509208VP0014X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1093986192OtherGROUP NPI
GA00342922AMedicaid
GA611242OtherBLUE CROSS BLUE SHIELD
GA130016081OtherRAILROAD MEDICARE
GA00342922AMedicaid