Provider Demographics
NPI:1255467684
Name:HYMAN, PAUL LOUIS (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:LOUIS
Last Name:HYMAN
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 1:18 PLEASANT ST UNIT 204
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2201
Mailing Address - Country:US
Mailing Address - Phone:207-249-6959
Mailing Address - Fax:
Practice Address - Street 1:18 PLEASANT ST UNIT 204
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2201
Practice Address - Country:US
Practice Address - Phone:207-249-6959
Practice Address - Fax:855-615-0545
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20220208000000X
MEMS20220207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
12097902OtherCAQH
12097902OtherCAQH