Provider Demographics
NPI:1790906378
Name:GIANNAS, APOSTOLOS JOHN (OD)
Entity Type:Individual
Prefix:DR
First Name:APOSTOLOS
Middle Name:JOHN
Last Name:GIANNAS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MITCHELL DR.
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1629
Mailing Address - Country:US
Mailing Address - Phone:410-569-0163
Mailing Address - Fax:
Practice Address - Street 1:7106 RIDGE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3875
Practice Address - Country:US
Practice Address - Phone:410-866-2022
Practice Address - Fax:410-866-2031
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0814152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT59942Medicare UPIN