Provider Demographics
NPI:1255901153
Name:PAVLOU, ATHANASIOS (MD)
Entity type:Individual
Prefix:
First Name:ATHANASIOS
Middle Name:
Last Name:PAVLOU
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 1:22 S GREENE ST.
Mailing Address - Street 2:DEPARTMENT OF DIAGNOSTIC RADIOLOGY & NUCLEAR MEDICINE,
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-328-9312
Mailing Address - Fax:410-328-9118
Practice Address - Street 1:22 S GREENE ST.
Practice Address - Street 2:DEPARTMENT OF DIAGNOSTIC RADIOLOGY & NUCLEAR MEDICINE,
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-328-9312
Practice Address - Fax:410-328-9118
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program