Provider Demographics
NPI:1427017680
Name:JOHN G GIRAGOS MD PA
Entity Type:Organization
Organization Name:JOHN G GIRAGOS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GARABED
Authorized Official - Last Name:GIRAGOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-493-1810
Mailing Address - Street 1:20 WEST COLONY PLACE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5577
Mailing Address - Country:US
Mailing Address - Phone:919-493-1810
Mailing Address - Fax:
Practice Address - Street 1:20 WEST COLONY PLACE
Practice Address - Street 2:SUITE 260
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5577
Practice Address - Country:US
Practice Address - Phone:919-493-1810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC168662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8935663Medicaid
201558Medicare ID - Type Unspecified
D83397Medicare UPIN