Provider Demographics
NPI:1689694101
Name:COELHO, PAUL CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:COELHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 OAK ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3975
Mailing Address - Country:US
Mailing Address - Phone:503-814-7246
Mailing Address - Fax:503-814-2484
Practice Address - Street 1:875 OAK ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3975
Practice Address - Country:US
Practice Address - Phone:503-814-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD260852081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00297503OtherRAILROAD MEDICARE
ORMD26085OtherMEDICAL LICENSE
H00384Medicare UPIN
ORP00297503OtherRAILROAD MEDICARE
ORMD26085OtherMEDICAL LICENSE