Provider Demographics
NPI:1265437511
Name:PAPANICOLAOU, GEORGE J (DO)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:J
Last Name:PAPANICOLAOU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:303 HAVERHILL ST # C
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-2101
Mailing Address - Country:US
Mailing Address - Phone:978-948-3902
Mailing Address - Fax:978-948-7530
Practice Address - Street 1:303 HAVERHILL ST # C
Practice Address - Street 2:
Practice Address - City:ROWLEY
Practice Address - State:MA
Practice Address - Zip Code:01969-2101
Practice Address - Country:US
Practice Address - Phone:978-948-3902
Practice Address - Fax:978-948-7530
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3173763Medicaid
MA3173763Medicaid
MAA23173Medicare ID - Type Unspecified