Provider Demographics
NPI:1467524819
Name:PAPAGIANNOPOULOS, MIKE (DC)
Entity Type:Individual
Prefix:
First Name:MIKE
Middle Name:
Last Name:PAPAGIANNOPOULOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19725 GERMANTOWN RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1206
Mailing Address - Country:US
Mailing Address - Phone:301-528-5477
Mailing Address - Fax:
Practice Address - Street 1:19725 GERMANTOWN RD
Practice Address - Street 2:SUITE E
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1206
Practice Address - Country:US
Practice Address - Phone:301-528-5477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD490395Medicare ID - Type Unspecified