Provider Demographics
NPI:1629015094
Name:KIRITSIS, PAUL GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GEORGE
Last Name:KIRITSIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:13700 SAINT FRANCIS BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3267
Practice Address - Country:US
Practice Address - Phone:804-379-2414
Practice Address - Fax:804-379-2413
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA101053625207XS0114X
VA0101053625207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA194785OtherANTHEM WEST END OPERATORY
VA540885859OtherC&O EMPLOYEE'S HEALTHCARE
VA6400418Medicaid
VA2138281OtherUNITED HEALTHCARE MAMSI
VA540885859OtherCOMPMANAGEMENT
VA540885859OtherCIGNA
VA540885859OtherCORVEL
VA0900927OtherUNITED HEALTHCARE
VA2366163OtherAETNA HMO
VA174628OtherANTHEM HEALTHKEEPERS
VA200039105OtherRAILROAD MEDICARE
VA1629015094Medicaid
VA33398OtherSH CARENET
VA289325OtherSOUTHERN HEALTH
VA36596OtherOPTIMA HEALTH
VA540885859OtherFIRST HEALTH/CCN
VA540885859OtherPRIVATE HEALTHCARE SYSTEM
VA540885859OtherFOCUS
VA200039105OtherRAILROAD MEDICARE
VA540885859OtherFOCUS
VAG96992Medicare UPIN
VA1629015094Medicaid