Provider Demographics
NPI:1447242946
Name:PAWLUS, JAMES M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:PAWLUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1187
Mailing Address - Country:US
Mailing Address - Phone:888-656-6020
Mailing Address - Fax:317-705-5060
Practice Address - Street 1:1441 RIDGE ST
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4211
Practice Address - Country:US
Practice Address - Phone:239-643-1155
Practice Address - Fax:239-643-9816
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME611162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058937300Medicaid
FL14698Medicare ID - Type Unspecified
FL058937300Medicaid