Provider Demographics
NPI:1730181405
Name:PAPADEAS, GREGORY G (DO)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:G
Last Name:PAPADEAS
Suffix:
Gender:M
Credentials:DO
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1390 S POTOMAC ST
Mailing Address - Street 2:SUITE 124
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-6165
Mailing Address - Country:US
Mailing Address - Phone:303-368-8611
Mailing Address - Fax:303-368-9787
Practice Address - Street 1:1390 S POTOMAC ST
Practice Address - Street 2:SUITE 124
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-6165
Practice Address - Country:US
Practice Address - Phone:303-368-8611
Practice Address - Fax:303-368-9787
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2020-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO29740207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01297407Medicaid
CO070012836OtherRR MEDICARE
CO070012836OtherRR MEDICARE
COE60019Medicare UPIN