Provider Demographics
NPI:1841285467
Name:PAUPORE, JOSEPH THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:PAUPORE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19171 MERRIMAN RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1754
Mailing Address - Country:US
Mailing Address - Phone:248-478-9898
Mailing Address - Fax:248-473-9870
Practice Address - Street 1:19171 MERRIMAN RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1754
Practice Address - Country:US
Practice Address - Phone:248-478-9898
Practice Address - Fax:248-473-9870
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012057207QA0000X, 207QA0401X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Not Answered207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Not Answered207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4506903Medicaid
MI5446534OtherAETNA ID
MI16325OtherMCARE ID
MI5821017OtherBCBS PIN
MI10920041OtherCIGNA PROVIDER ID
MI10920041OtherCIGNA PROVIDER ID
MIF98611Medicare UPIN