Provider Demographics
NPI:1932268729
Name:WINTERS, PAUL JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOHN
Last Name:WINTERS
Suffix:
Gender:M
Credentials:DC
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 288
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:20622-0288
Mailing Address - Country:US
Mailing Address - Phone:301-884-3423
Mailing Address - Fax:301-884-0371
Practice Address - Street 1:29770 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE HALL
Practice Address - State:MD
Practice Address - Zip Code:20622-3191
Practice Address - Country:US
Practice Address - Phone:301-884-3423
Practice Address - Fax:301-884-0371
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01887111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD994M823FMedicare ID - Type Unspecified
MDU67669Medicare UPIN