Provider Demographics
NPI:1497860167
Name:KAPLANIS, PAUL TRAIANOS (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:TRAIANOS
Last Name:KAPLANIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1234 E DUPONT RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1545
Mailing Address - Country:US
Mailing Address - Phone:260-373-9700
Mailing Address - Fax:260-373-9740
Practice Address - Street 1:6130 TRIER RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-5339
Practice Address - Country:US
Practice Address - Phone:260-422-2481
Practice Address - Fax:260-969-3067
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031926A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000595578OtherANTHEM
IN100080210Medicaid
IN080130049OtherMEDICARE RR
IN100080210Medicaid
IN259060JMedicare PIN
IN055250EEMedicare ID - Type Unspecified