Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 216706 | MA |
NPI | 1083615744 |
---|---|
Provider Name | Achilles K Papavasiliou |
First Address | Hyannis, MA 02601-3845 |
Second Address | Hyannis, MA 02601-3845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 16/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2005816 | (05) | MA |
H84927 | (02) |