Provider Demographics
NPI:1013923424
Name:PAULO, JIMMY MARTINS (MD)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:MARTINS
Last Name:PAULO
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 1:2525 E CAMELBACK RD STE 1100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4282
Mailing Address - Country:US
Mailing Address - Phone:602-778-3603
Mailing Address - Fax:602-324-2308
Practice Address - Street 1:1 CLARA MAASS DR STE 202
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2433
Practice Address - Fax:973-450-2434
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08106500208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0126888Medicaid
NJ0126888Medicaid
NJ103601TN1Medicare PIN