Provider Demographics
NPI:1770528754
Name:PAUL, MICHAEL J (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:PAUL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:851 ROUTE 73 N STE D
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1275
Mailing Address - Country:US
Mailing Address - Phone:856-372-9422
Mailing Address - Fax:856-409-0393
Practice Address - Street 1:851 ROUTE 73 N STE D
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1275
Practice Address - Country:US
Practice Address - Phone:856-372-9422
Practice Address - Fax:856-409-0393
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB07847800208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ097739STQMedicare ID - Type Unspecified
NJI48750Medicare UPIN