Provider Demographics
NPI:1144243015
Name:CAHIWAT, PAUL SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SAMUEL
Last Name:CAHIWAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:21 EDGEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:973-395-1550
Mailing Address - Fax:973-395-1556
Practice Address - Street 1:60 EVERGREEN PLACE
Practice Address - Street 2:SUITE 400
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018
Practice Address - Country:US
Practice Address - Phone:973-395-1550
Practice Address - Fax:973-395-1556
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02865400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1339401Medicaid
NJC53285Medicare UPIN
NJ1339401Medicaid