Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 50859 | WI |
N | 208600000X | Surgeon | 50859 | WI |
Y | 2086X0206X | Surgical Oncologist | 50859 | WI |
N | 2086X0206X | Surgical Oncologist | MD430118 | PA |
NPI | 1417000142 |
---|---|
Provider Name | Dr. Sam George Pappas |
First Address | Milwaukee, WI 53226-3522 |
Second Address | Milwaukee, WI 53226-3522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 04/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1417000142 | (05) | WI |