Provider Demographics
NPI:1467549030
Name:NERZ, PAUL MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:NERZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3476 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SHINGLE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8813
Mailing Address - Country:US
Mailing Address - Phone:916-502-1781
Mailing Address - Fax:
Practice Address - Street 1:2844 COLOMA ST
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-4406
Practice Address - Country:US
Practice Address - Phone:916-871-6712
Practice Address - Fax:530-621-7707
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12102207QA0401X
CAG35504207QA0401X
DEC1-0004019207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA080180953OtherRAILROAD MEDICARE
CA080180953OtherRAILROAD MEDICARE
CAA46378Medicare UPIN