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Individual
GEORGE C XAKELLIS JR.
Active
Individual
GEORGE C XAKELLIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD029031E
PA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MD029031E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012794100001
—
PA
01
—
1738142
HIGHMARK BLUE SHIELD
PA
01
—
50047703
CAPITAL BLUE CROSS
PA
01
—
B18104
HEALTH ASSURANCE
PA
Enumeration date
09/27/2005
Last updated
04/03/2013
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