Provider Demographics
NPI:1619944055
Name:PAPADOPOULOS, SPYRIDON G (MD)
Entity Type:Individual
Prefix:DR
First Name:SPYRIDON
Middle Name:G
Last Name:PAPADOPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 MARION ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1514
Mailing Address - Country:US
Mailing Address - Phone:303-830-7337
Mailing Address - Fax:303-830-1890
Practice Address - Street 1:1625 MARION
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218
Practice Address - Country:US
Practice Address - Phone:303-830-7337
Practice Address - Fax:303-830-1890
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31206208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01312065Medicaid
F76477Medicare UPIN