Provider Demographics
NPI:1669461497
Name:PAISTE, JUHAN
Entity Type:Individual
Prefix:
First Name:JUHAN
Middle Name:
Last Name:PAISTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1717 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1801
Practice Address - Country:US
Practice Address - Phone:800-822-8816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33394207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0448234OtherKHP CENTRAL
PA20021532OtherAMERIHEALTH MERCY
PA448234OtherHIGHMARK
PA0071263000OtherINDEP. BLUE CROSS
PA0000000141600OtherTHREE RIVERS
PA0017575520003Medicaid
PA01510387OtherGATEWAY
PA30006428OtherKEYSTONE MERCY
PA448234OtherHIGHMARK
PAH08031Medicare UPIN
PA050092213Medicare PIN