Provider Demographics
NPI:1912391681
Name:HSIEH, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:HSIEH
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 1:6066 RIDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3220
Mailing Address - Country:US
Mailing Address - Phone:810-733-5248
Mailing Address - Fax:
Practice Address - Street 1:6066 RIDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3220
Practice Address - Country:US
Practice Address - Phone:810-733-5248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI68115876Medicaid