Provider Demographics
NPI:1174193759
Name:KAKOULLIS, LOUKAS (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUKAS
Middle Name:
Last Name:KAKOULLIS
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 1:330 MOUNT AUBURN STREET
Mailing Address - Street 2:MOUNT AUBURN HOSPITAL. DEPARTMENT OF INTERNAL MEDICINE
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:617-499-5160
Mailing Address - Fax:
Practice Address - Street 1:330 MOUNT AUBURN STREET
Practice Address - Street 2:MOUNT AUBURN HOSPITAL. DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-499-5160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program