Provider Demographics
NPI:1053555912
Name:GIANNAKOPOULOS, NADIA VICKI (MD PHD)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:VICKI
Last Name:GIANNAKOPOULOS
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10655 59 STREET NW
Mailing Address - Street 2:
Mailing Address - City:EDMONTON
Mailing Address - State:AB
Mailing Address - Zip Code:T6A2K5
Mailing Address - Country:CA
Mailing Address - Phone:780-466-7073
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF ALBERTA HOSPITAL
Practice Address - Street 2:8440 112 STREET NW
Practice Address - City:EDMONTON
Practice Address - State:AB
Practice Address - Zip Code:T6G 2B7
Practice Address - Country:CA
Practice Address - Phone:780-407-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML60095933207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology