Provider Demographics
NPI:1265617088
Name:VISER, PAUL EDWARD (MD PA)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EDWARD
Last Name:VISER
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 BEAMAN ST STE 401
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2689
Mailing Address - Country:US
Mailing Address - Phone:910-592-2285
Mailing Address - Fax:910-592-3548
Practice Address - Street 1:603 BEAMAN ST STE 401
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2689
Practice Address - Country:US
Practice Address - Phone:910-592-2285
Practice Address - Fax:910-592-3548
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7985098Medicaid
NC85098OtherBCBS
NC2320395Medicare PIN
NC85098OtherBCBS
C69210Medicare UPIN