Provider Demographics
NPI:1417955865
Name:PAUL, MATTHEW D (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:D
Last Name:PAUL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:69 SAND PIT RD
Mailing Address - Street 2:SUITE101
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4004
Mailing Address - Country:US
Mailing Address - Phone:203-791-2020
Mailing Address - Fax:203-778-6238
Practice Address - Street 1:69 SAND PIT RD
Practice Address - Street 2:SUITE101
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4004
Practice Address - Country:US
Practice Address - Phone:203-791-2020
Practice Address - Fax:203-778-6238
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2021-03-29
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Provider Licenses
StateLicense IDTaxonomies
CT025616207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001256163Medicaid