Provider Demographics
NPI:1427181270
Name:PAULL, ROBERT MICHAEL (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:PAULL
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 1:4 PROGRESS ST
Mailing Address - Street 2:SUITE B7
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1199
Mailing Address - Country:US
Mailing Address - Phone:908-754-0770
Mailing Address - Fax:908-754-4731
Practice Address - Street 1:4 PROGRESS ST
Practice Address - Street 2:SUITE B7
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1199
Practice Address - Country:US
Practice Address - Phone:908-754-0770
Practice Address - Fax:908-754-4731
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04449900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
19F18OtherEMPIRE BCBS
J23569OtherHEALTHNET
22ONMEDCAREPROOtherANTHEM BCBS
2967541OtherOXFORD
146750153948OtherHUMANA
701128OtherUS FAMILY
0488551OtherAETNA HEALTH MANAGEMENT
ROBERT M. PAULL MDOtherGENERIC
78022229675410OtherHORIZON BCBS OF NJ
NJ9999OtherTHE MUTUAL OF OMAHA CO
PR57396850002OtherCIGNA
17373OtherAMERIGROUP
A0000OtherBCBS OF FLORIDA
78022229675410OtherHORIZON BCBS OF NJ
J23569OtherHEALTHNET