Provider Demographics
NPI:1336301043
Name:PAUN, MARK ALFRED WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALFRED WILLIAM
Last Name:PAUN
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 1882
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-1882
Mailing Address - Country:US
Mailing Address - Phone:706-509-3040
Mailing Address - Fax:
Practice Address - Street 1:1328 JOE FRANK HARRIS PKWY SE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-4221
Practice Address - Country:US
Practice Address - Phone:770-382-0029
Practice Address - Fax:770-387-0306
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA066048207Q00000X
FLME117502207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine