Provider Demographics
NPI:1265415145
Name:MUIZELAAR, J. PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:J.
Middle Name:PAUL
Last Name:MUIZELAAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:PAUL
Other - Last Name:MUIZELAAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1600 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE B500
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701
Mailing Address - Country:US
Mailing Address - Phone:304-691-1787
Mailing Address - Fax:304-691-8711
Practice Address - Street 1:1600 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE B500
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701
Practice Address - Country:US
Practice Address - Phone:304-691-1787
Practice Address - Fax:304-691-8711
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASFP4207T00000X
WV00004207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery