Provider Demographics
NPI:1295702421
Name:PAUERS, RANDY S (DPM)
Entity type:Individual
Prefix:MR
First Name:RANDY
Middle Name:S
Last Name:PAUERS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7423 W GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-4614
Mailing Address - Country:US
Mailing Address - Phone:414-258-8945
Mailing Address - Fax:414-258-7712
Practice Address - Street 1:7423 W GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-4614
Practice Address - Country:US
Practice Address - Phone:414-258-8945
Practice Address - Fax:414-258-7712
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI425-025213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist