Provider Demographics
NPI:1548392608
Name:MITTMAN, PAUL ALLEN (ND)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALLEN
Last Name:MITTMAN
Suffix:
Gender:M
Credentials:ND
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Mailing Address - Street 1:8010 E MCDOWELL RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3867
Mailing Address - Country:US
Mailing Address - Phone:480-970-0000
Mailing Address - Fax:480-970-0003
Practice Address - Street 1:8010 E MCDOWELL RD
Practice Address - Street 2:SUITE 111
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3867
Practice Address - Country:US
Practice Address - Phone:480-970-0000
Practice Address - Fax:480-970-0003
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ97-504175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ97-504OtherLICENSE