Provider Demographics
NPI:1235550211
Name:KARAMBELLAS, GEORGE ANTHONY (PA)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:ANTHONY
Last Name:KARAMBELLAS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4602
Mailing Address - Country:US
Mailing Address - Phone:419-226-4310
Mailing Address - Fax:419-226-4315
Practice Address - Street 1:730 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4602
Practice Address - Country:US
Practice Address - Phone:419-226-4310
Practice Address - Fax:419-226-4315
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107722363A00000X
OH50005705RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0L5BOtherBCBS OF FLORIDA
FLHQ7602Medicare PIN
FL40935BMedicare PIN
FLY0L5BOtherBCBS OF FLORIDA