Provider Demographics
NPI:1598704660
Name:YOUNG, PAULA (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:412 LIBBIE AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2659
Mailing Address - Country:US
Mailing Address - Phone:804-282-8082
Mailing Address - Fax:804-282-9082
Practice Address - Street 1:1506 WILLOW LAWN DR
Practice Address - Street 2:SUITE 205
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3413
Practice Address - Country:US
Practice Address - Phone:804-282-8082
Practice Address - Fax:804-282-9082
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2015-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101239130208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010225018Medicaid