Provider Demographics
NPI:1649272071
Name:SAUERS, PAUL WILLIAM (DO, LACC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:WILLIAM
Last Name:SAUERS
Suffix:
Gender:M
Credentials:DO, LACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 BIANCA AVE
Mailing Address - Street 2:
Mailing Address - City:CARNEYS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08069-2633
Mailing Address - Country:US
Mailing Address - Phone:856-299-0002
Mailing Address - Fax:856-299-6169
Practice Address - Street 1:298 BIANCA AVE
Practice Address - Street 2:
Practice Address - City:CARNEYS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08069-2633
Practice Address - Country:US
Practice Address - Phone:856-299-0002
Practice Address - Fax:856-299-6169
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB2592900207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0085053000OtherAMERIHEALTH
19214800OtherFEDERAL BLACK LUNG
NJ3035107Medicaid
33927OtherAETNA
222360942OtherFEDERAL TAX ID
445113645OtherRAILROAD MEDICARE
1462401OtherMINE WORKERS
SA0000029-02OtherAMERICHOICE
156634OtherBLUE SHIELD OF PA
C52706Medicare UPIN