Provider Demographics
NPI:1851587778
Name:PAPADONIKOLAKIS, ANASTASIOS (MD)
Entity Type:Individual
Prefix:
First Name:ANASTASIOS
Middle Name:
Last Name:PAPADONIKOLAKIS
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 1:4515 PREMIER DR
Mailing Address - Street 2:STE 307
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8357
Mailing Address - Country:US
Mailing Address - Phone:336-802-2250
Mailing Address - Fax:336-881-3890
Practice Address - Street 1:1701 WESTCHESTER DR
Practice Address - Street 2:STE 850
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7008
Practice Address - Country:US
Practice Address - Phone:336-802-2536
Practice Address - Fax:336-802-2534
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127089207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1851587778Medicaid
NC1851587778Medicaid
NCNC1095CMedicare PIN