Basic Information
Provider Information
NPI: 1366886749
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAPAILIADIS
FirstName: KOSMAS
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1401 S JOYCE ST
Address2: APT 1513
City: ARLINGTON
State: VA
PostalCode: 222021874
CountryCode: US
TelephoneNumber: 3478161460
FaxNumber:  
Practice Location
Address1: 110 IRVING ST NW
Address2: SUITE 2A50
City: WASHINGTON
State: DC
PostalCode: 200103017
CountryCode: US
TelephoneNumber: 2028770393
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/29/2013
LastUpdateDate: 11/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XMD043988DCY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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