Provider Demographics
NPI:1295918027
Name:PAULI, SAMUEL ALLEN (MD,)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ALLEN
Last Name:PAULI
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 1:450 BEDFORD ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-1520
Mailing Address - Country:US
Mailing Address - Phone:180-085-8483
Mailing Address - Fax:
Practice Address - Street 1:450 BEDFORD ST STE 1000
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-1520
Practice Address - Country:US
Practice Address - Phone:180-085-8483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-16
Last Update Date:2018-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI13597207VE0102X
GA60962207VE0102X
MA246464207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology