Provider Demographics
NPI:1417047762
Name:EHRMANN, PAUL ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ROBERT
Last Name:EHRMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 CROOKS RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-4049
Mailing Address - Country:US
Mailing Address - Phone:248-543-2000
Mailing Address - Fax:248-543-2043
Practice Address - Street 1:2033 CROOKS RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-4049
Practice Address - Country:US
Practice Address - Phone:248-543-2000
Practice Address - Fax:248-543-2043
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007918207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI382719497OtherTAX ID#
MI382719497OtherTAX ID#
MIP54840001Medicare PIN