Provider Demographics
NPI:1043258791
Name:SPYROPOULOS, GEORGE NICHOLAS (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:NICHOLAS
Last Name:SPYROPOULOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 W CHESTER PIKE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7995
Mailing Address - Country:US
Mailing Address - Phone:610-738-9002
Mailing Address - Fax:610-738-9101
Practice Address - Street 1:1646 W CHESTER PIKE
Practice Address - Street 2:SUITE 12
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7995
Practice Address - Country:US
Practice Address - Phone:610-738-9002
Practice Address - Fax:610-738-9101
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008304L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01532623Medicaid
PA774779NB6Medicare ID - Type UnspecifiedMEDICARE ID #
PAG03441Medicare UPIN