Provider Demographics
NPI:1982680427
Name:WEHRUM, PAUL JR (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:WEHRUM
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 BETHESDA DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1800
Mailing Address - Country:US
Mailing Address - Phone:740-454-4561
Mailing Address - Fax:740-454-4653
Practice Address - Street 1:975 BETHESDA DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-7500
Practice Address - Country:US
Practice Address - Phone:740-454-6808
Practice Address - Fax:740-454-2236
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003559W207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000185170OtherANTHEM PIN
OH311413469028OtherCARESOURCE PIN
WE0640482OtherMEDICARE PTAN
CA1586OtherGROUP MEDICARE RAILROAD
OH000000177073OtherUNISON PIN
OH0658373Medicaid
OH0700564OtherUHC PIN
OH0989499OtherMEDICAID GROUP
OH160051599OtherMEDICARE RAILROAD
OH000000177073OtherUNISON PIN
CA1586OtherGROUP MEDICARE RAILROAD
OH160051599OtherMEDICARE RAILROAD
OH0700564OtherUHC PIN