Provider Demographics
NPI:1710629829
Name:PAULSEN, MATTHEW JOEL SR
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JOEL
Last Name:PAULSEN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9301 HIGHWAY 178 S
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:SC
Mailing Address - Zip Code:29138-9522
Mailing Address - Country:US
Mailing Address - Phone:864-310-9500
Mailing Address - Fax:864-719-3020
Practice Address - Street 1:212 N CREEK BLVD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-9006
Practice Address - Country:US
Practice Address - Phone:864-310-9500
Practice Address - Fax:864-719-3020
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment