Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 04-29323 | KS |
NPI | 1013984699 |
---|---|
Provider Name | Dr. Paul C Pappademos |
First Address | Wichita, KS 67226-8112 |
Second Address | Wichita, KS 67226-8112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2006 |
Last Update Date | 27/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200332890A | (05) | KS |
I20574 | (02) | KS |