Ioannis Koutlas
Oral and Maxillofacial Pathology
515 Delaware St Se 16-116 Moos Tower
Minneapolis
, Minnesota 55455-0357
Ioannis Koutlas
Oral and Maxillofacial Pathology
515 Delaware St Se 16-116 Moos Tower
Minneapolis
, Minnesota 55455-0357
(612) 626-5844
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Ioannis Koutlas
- 515 Delaware St Se 16-116 Moos Tower
- Minneapolis, MN
- Zip : 55455-0357
- Phone : (612) 626-5844
Second Address
- Ioannis Koutlas
- 515 Delaware St Se 16-116 Moos Tower
- Minneapolis, MN
- Zip : 55455-0357
- Phone : (612) 626-5844
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Is Ioannis Koutlas a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | D11102 | MN |
National Provider Identifier
| NPI | 1447361332 |
|---|---|
| Provider Name | Ioannis Koutlas |
| First Address | Minneapolis, MN 55455-0357 |
| Second Address | Minneapolis, MN 55455-0357 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/08/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.