Provider Demographics
NPI:1578666145
Name:SARVER, PAUL A (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:SARVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 S ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-3201
Mailing Address - Country:US
Mailing Address - Phone:719-392-1218
Mailing Address - Fax:
Practice Address - Street 1:3031 S ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916-3201
Practice Address - Country:US
Practice Address - Phone:719-392-1218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4570520Medicaid
MI950C314890OtherBCBS
T98877Medicare UPIN
COC810861Medicare PIN
MI950C314890OtherBCBS