Individual
DR. GEORGANN A POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8751 BRECKSVILLE RD, SUITE 50, BRECKSVILLE, OH 44141-1949
(440) 262-5520
Mailing address
8751 BRECKSVILLE RD, SUITE 50, BRECKSVILLE, OH 44141-1949
(440) 262-5520
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
120088
OH
207N00000X
Dermatology Physician
MD442702
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35120088
OHIO MEDICAL LICENSE
OH
01
—
MD442702
PENNSYLVANIA LICENSE NUMBER
PA
Enumeration date
08/28/2007
Last updated
01/10/2013
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