Provider Demographics
NPI:1720081391
Name:PAUL, RICHARD CAMPBELL (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:CAMPBELL
Last Name:PAUL
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 1:33663 BAYVIEW MEDICAL DR
Mailing Address - Street 2:UNIT 1
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1663
Mailing Address - Country:US
Mailing Address - Phone:302-645-3555
Mailing Address - Fax:302-644-3560
Practice Address - Street 1:34431 KING STREET ROW
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4787
Practice Address - Country:US
Practice Address - Phone:302-645-2666
Practice Address - Fax:302-645-6448
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0004803208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000741801Medicaid
DE000H14U64OtherMEDICARE ID
DEG33121Medicare UPIN