Provider Demographics
NPI:1184868952
Name:PAPAVASSILIOU-BAJIC, PAULIE (MDPHD)
Entity type:Individual
Prefix:DR
First Name:PAULIE
Middle Name:
Last Name:PAPAVASSILIOU-BAJIC
Suffix:
Gender:F
Credentials:MDPHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 MILSTEAD AVENUE, N.E.
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1412 MILSTEAD AVENUE, N.E.
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012
Practice Address - Country:US
Practice Address - Phone:770-918-3905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME136213207ZP0102X
NY292048-01207ZP0102X
MDD0082138207ZP0102X
GA72068207ZP0102X
NC2012-02379207ZP0102X
CAA155326207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology