Provider Demographics
NPI:1518936921
Name:PAUL, DHARAM AGGARWAL (MD)
Entity Type:Individual
Prefix:DR
First Name:DHARAM
Middle Name:AGGARWAL
Last Name:PAUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-470-5842
Mailing Address - Fax:251-470-5809
Practice Address - Street 1:2451 FILLINGIM ST
Practice Address - Street 2:MASTIN BLDG
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2238
Practice Address - Country:US
Practice Address - Phone:251-470-5842
Practice Address - Fax:251-470-5809
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17892207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009912583Medicaid
AL51544942OtherBCBS-FILLINGIM
MS06739565Medicaid
AL009912581Medicaid
AL009912582Medicaid
AL51023295PAUOtherBLUE CROSS BLUE SHIELD
AL51544932OtherBCBS-GIRBY RD
AL51545155OtherBCBS-STANTON RD
ALPA000023295Medicaid
AL009912583Medicaid
AL009912581Medicaid
AL51544942OtherBCBS-FILLINGIM