Provider Demographics
NPI:1326159088
Name:TENDER, PAUL M (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:TENDER
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 1:963 N MCQUEEN RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8149
Mailing Address - Country:US
Mailing Address - Phone:480-646-8440
Mailing Address - Fax:480-646-8441
Practice Address - Street 1:963 N MCQUEEN RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8149
Practice Address - Country:US
Practice Address - Phone:480-646-8440
Practice Address - Fax:480-646-8441
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086469208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ099181Medicaid
F64936Medicare UPIN
ILF64936Medicare UPIN
IL6447860011Medicare NSC