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Individual

DR. PANAGIOTIS PAULUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2210 BARRON RD, SUITE 114, POPLAR BLUFF, MO 63901-1908
(573) 686-4800
(573) 686-8448
Mailing address
2210 BARRON RD, SUITE 114, POPLAR BLUFF, MO 63901-1908
(573) 686-4800
(573) 686-8448

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R6D36
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123992
BLUE CROSS BLUE SHIELD
01
180034174
MEDICARE RAILROAD
MO
05
203225719
MO
Enumeration date
01/25/2006
Last updated
07/09/2007
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