Provider Demographics
NPI:1710039128
Name:NORVELL, PAUL F III
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:NORVELL
Suffix:III
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 1:24 BROOKHILL DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1301
Mailing Address - Country:US
Mailing Address - Phone:302-454-3020
Mailing Address - Fax:302-454-0298
Practice Address - Street 1:24 BROOKHILL DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1301
Practice Address - Country:US
Practice Address - Phone:302-454-3020
Practice Address - Fax:302-454-0298
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000040901Medicaid