Provider Demographics
NPI:1750355574
Name:MICHAS, PAUL A (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:MICHAS
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:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31702-0407
Mailing Address - Country:US
Mailing Address - Phone:229-883-4707
Mailing Address - Fax:229-435-1038
Practice Address - Street 1:619 POINTE NORTH BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31721-1514
Practice Address - Country:US
Practice Address - Phone:229-883-4707
Practice Address - Fax:229-435-1038
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041172207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA200035716OtherRAILROAD MEDICARE
GA000833984AMedicaid
372315400OtherWORKERS' COMPENSATION
GA769438OtherBCBSGA
GA20BBDTTMedicare ID - Type Unspecified
GA200035716OtherRAILROAD MEDICARE