Provider Demographics
NPI:1578643664
Name:BURNS, PAUL R (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:121 MEDICAL CENTER DR
Mailing Address - Street 2:3100
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2653
Mailing Address - Country:US
Mailing Address - Phone:207-729-7939
Mailing Address - Fax:207-725-4717
Practice Address - Street 1:121 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 3100
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-729-7939
Practice Address - Fax:207-725-4717
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2015-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME014720207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME292790099Medicaid
ME292790099Medicaid
MM7280Medicare PIN