Provider Demographics
NPI:1952585382
Name:PAULA RECHNER MD, PC
Entity type:Organization
Organization Name:PAULA RECHNER MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RECHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:906-253-9770
Mailing Address - Street 1:333 MAGAZINE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1867
Mailing Address - Country:US
Mailing Address - Phone:906-253-9770
Mailing Address - Fax:906-253-9772
Practice Address - Street 1:333 MAGAZINE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-1867
Practice Address - Country:US
Practice Address - Phone:906-253-9770
Practice Address - Fax:906-253-9772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077090174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0201701371OtherBLUE CROSS BLUE SHIELD
MI4842497Medicaid
MI0N83810Medicare PIN
MI4842497Medicaid