Provider Demographics
NPI:1770515082
Name:WESTFALL, PAUL K (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:K
Last Name:WESTFALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:33 PARDON HILL RD
Mailing Address - Street 2:
Mailing Address - City:S DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-1594
Mailing Address - Country:US
Mailing Address - Phone:508-636-4521
Mailing Address - Fax:508-636-7160
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-636-4521
Practice Address - Fax:508-636-7160
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2170572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2011123Medicaid
MAA35510Medicare ID - Type Unspecified
MA2011123Medicaid