Provider Demographics
NPI:1386841187
Name:MAZARIS, PAUL ALEX (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ALEX
Last Name:MAZARIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6790
Mailing Address - Fax:616-486-6702
Practice Address - Street 1:25 MICHIGAN ST NE STE 6100
Practice Address - Street 2:SPECTRUM HEALTH MEDICAL GROUP NEUROSURGERY
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2561
Practice Address - Country:US
Practice Address - Phone:616-267-7900
Practice Address - Fax:616-267-7901
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2021-03-08
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Provider Licenses
StateLicense IDTaxonomies
CT052805207T00000X
MI4301090301207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery