Provider Demographics
NPI:1982694006
Name:BOTELHO, PAUL J (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:BOTELHO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 FAUNCE CORNER RD
Mailing Address - Street 2:STE 110
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1255
Mailing Address - Country:US
Mailing Address - Phone:508-717-0266
Mailing Address - Fax:508-717-0268
Practice Address - Street 1:500 FAUNCE CORNER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:NO DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2972
Practice Address - Country:US
Practice Address - Phone:508-717-0270
Practice Address - Fax:508-995-3060
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2023-07-13
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Provider Licenses
StateLicense IDTaxonomies
MA204647207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3205304Medicaid
H11812Medicare UPIN
MA3205304Medicaid