Provider Demographics
NPI:1326721705
Name:BOHMS, PAUL A
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:BOHMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 W HOME AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-1460
Mailing Address - Country:US
Mailing Address - Phone:810-516-5460
Mailing Address - Fax:
Practice Address - Street 1:2091 PROFESSIONAL DR STE D
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3657
Practice Address - Country:US
Practice Address - Phone:810-732-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist