Provider Demographics
NPI:1447451745
Name:FILIPPOPOULOS, THEODOROS (MD)
Entity type:Individual
Prefix:
First Name:THEODOROS
Middle Name:
Last Name:FILIPPOPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 REGENCY PLZ
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-3160
Mailing Address - Country:US
Mailing Address - Phone:617-523-7900
Mailing Address - Fax:
Practice Address - Street 1:MEEI
Practice Address - Street 2:243 CHARLES STREET, OPHTHAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-523-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231235207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology