Provider Demographics
NPI:1356389654
Name:BLEICHER, PAUL A (MD, PHD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:BLEICHER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-2517
Mailing Address - Country:US
Mailing Address - Phone:781-738-6721
Mailing Address - Fax:
Practice Address - Street 1:1380 SOLDIERS FIELD RD
Practice Address - Street 2:HUMEDICA
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-1023
Practice Address - Country:US
Practice Address - Phone:781-738-6721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55646207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology