Provider Demographics
NPI:1962464842
Name:PAPPAS, JOHN L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:PAPPAS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3601 W 13 MILE RD
Mailing Address - Street 2:ANESTHESIOLOGY DEPT
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073
Mailing Address - Country:US
Mailing Address - Phone:248-723-1635
Mailing Address - Fax:248-723-1681
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:ANESTHESIOLOGY DEPT
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-723-1635
Practice Address - Fax:248-723-1681
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301057911207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G36140Medicare UPIN