Provider Demographics
NPI:1992751598
Name:PAPPAS, SAM GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:GEORGE
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAM
Other - Middle Name:GEORGE
Other - Last Name:PAPPAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8020 CORTELAND DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2325
Mailing Address - Country:US
Mailing Address - Phone:865-690-4546
Mailing Address - Fax:865-690-6851
Practice Address - Street 1:8020 CORTELAND DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2325
Practice Address - Country:US
Practice Address - Phone:865-690-4546
Practice Address - Fax:865-690-6851
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5653174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3154306Medicare ID - Type Unspecified