Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 029509 | GA |
NPI | 1033198809 |
---|---|
Provider Name | Dr. Stephen George Pappas |
First Address | Brunswick, GA 31520-4725 |
Second Address | Brunswick, GA 31520-4725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 15/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00342922A | (05) | GA |
1093986192 | GROUP NPI (01) | GA |
130016081 | RAILROAD MEDICARE (01) | GA |
611242 | BLUE CROSS BLUE SHIELD (01) | GA |
D41858 | (02) | GA |