Provider Demographics
NPI:1265459218
Name:BULAT, PAUL I (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:I
Last Name:BULAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1070
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02722-1070
Mailing Address - Country:US
Mailing Address - Phone:508-676-3292
Mailing Address - Fax:508-672-7181
Practice Address - Street 1:277 PLEASANT ST
Practice Address - Street 2:PRIMA CARE, PC
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-676-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA43492207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A67870Medicare UPIN
MAN01882Medicare ID - Type Unspecified