Provider Demographics
NPI:1083606016
Name:PETROPOULOS, ANNA E (MD, FRCS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:E
Last Name:PETROPOULOS
Suffix:
Gender:F
Credentials:MD, FRCS
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:PETROPOULOS
Other - Last Name:WEISSLEDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, FRCS
Mailing Address - Street 1:80 LINDALL ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2135
Mailing Address - Country:US
Mailing Address - Phone:978-739-9500
Mailing Address - Fax:978-739-9502
Practice Address - Street 1:80 LINDALL ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2135
Practice Address - Country:US
Practice Address - Phone:978-739-9500
Practice Address - Fax:978-739-9502
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154747207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA19916OtherHARVARD PILGRIM
MABP6821599OtherDEA
MABP6821599OtherDEA
MAA32761Medicare ID - Type Unspecified