Provider Demographics
NPI:1205819778
Name:ELMINOWSKI, PAUL JUDE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JUDE
Last Name:ELMINOWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 FOX DEN DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-6951
Mailing Address - Country:US
Mailing Address - Phone:704-282-9988
Mailing Address - Fax:704-282-9990
Practice Address - Street 1:4612 W HIGHWAY 74
Practice Address - Street 2:SUITE F
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8465
Practice Address - Country:US
Practice Address - Phone:704-282-9988
Practice Address - Fax:704-282-9990
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2453953AMedicare ID - Type Unspecified
U08134Medicare UPIN