Provider Demographics
NPI:1134285927
Name:SPECTOR, PAUL MITCHELL (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MITCHELL
Last Name:SPECTOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7329 BOULDER VIEW LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4953
Mailing Address - Country:US
Mailing Address - Phone:804-320-8570
Mailing Address - Fax:804-320-8572
Practice Address - Street 1:7329 BOULDER VIEW LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4953
Practice Address - Country:US
Practice Address - Phone:804-320-8570
Practice Address - Fax:804-320-8572
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01020230762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB09881Medicare UPIN