Provider Demographics
NPI:1306849716
Name:PAPPAS, STEPHEN S JR (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:PAPPAS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6420 ROCKLEDGE DR
Mailing Address - Street 2:STE 4900
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-7848
Mailing Address - Country:US
Mailing Address - Phone:301-571-5000
Mailing Address - Fax:301-571-4307
Practice Address - Street 1:6420 ROCKLEDGE DR
Practice Address - Street 2:STE 4900
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7848
Practice Address - Country:US
Practice Address - Phone:301-571-5000
Practice Address - Fax:301-571-4307
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053846207W00000X, 207WX0107X
DCMD20175207W00000X, 207WX0107X
MDD0044710207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4332262OtherAETNA
MDLW08OtherCAREFIRST
DC74570001OtherCAREFIRST
MD087111700Medicaid
330652OtherMDIPA, OPT CHOICE, MAMSI
DC74570001OtherCAREFIRST
DCG00698Medicare PIN