Provider Demographics
NPI:1376530261
Name:BJORN, PAUL ANDERS (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANDERS
Last Name:BJORN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7757 AUBURN RD STE 15
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9604
Mailing Address - Country:US
Mailing Address - Phone:440-709-9150
Mailing Address - Fax:440-354-7420
Practice Address - Street 1:7590 AUBURN RD
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-9176
Practice Address - Country:US
Practice Address - Phone:440-350-0832
Practice Address - Fax:440-579-0191
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.007692207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2298400Medicaid
OHH53890Medicare UPIN
OH4065891Medicare ID - Type Unspecified
OH4065893Medicare ID - Type Unspecified
OH2298400Medicaid