Provider Demographics
NPI:1649385634
Name:LEDAKIS, PANAYOTIS (MD)
Entity Type:Individual
Prefix:
First Name:PANAYOTIS
Middle Name:
Last Name:LEDAKIS
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 1:227 ST PAUL PLACE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2001
Mailing Address - Country:US
Mailing Address - Phone:410-783-5858
Mailing Address - Fax:410-783-5864
Practice Address - Street 1:227 ST PAUL PLACE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2001
Practice Address - Country:US
Practice Address - Phone:410-783-5858
Practice Address - Fax:410-783-5864
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD047934207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7223044OtherAETNA
64123801OtherCAREFIRST MD
R8440003OtherCAREFIRST DC
R8440003OtherCAREFIRST DC
MD123LH359Medicare ID - Type Unspecified