1538149299 NPI number — DR. MICHAEL J PARIS DPM

Table of content: DR. MICHAEL J PARIS DPM (NPI 1538149299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538149299 NPI number — DR. MICHAEL J PARIS DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARIS
Provider First Name:
MICHAEL
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538149299
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 FAME AVE
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
HANOVER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17331-1587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-632-5264
Provider Business Mailing Address Fax Number:
717-632-1165

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 FAME AVE
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
HANOVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17331-1587
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-632-5264
Provider Business Practice Location Address Fax Number:
717-632-1165
Provider Enumeration Date:
01/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  SC004734L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 201329679 . This is a "HEALTH ASSURANCE/AMERICA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1467348 . This is a "FEDERAL BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1960648002 . This is a "MEDICAL ASSISTANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 201329679 . This is a "SOUTH CENTRAL PREFERRED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50038811 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2113979 . This is a "OPTIMUM CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2113979 . This is a "ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: J902 . This is a "CAPITAL BCBS OF DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1467348 . This is a "AMERIHEALTH ADMINISTRATOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1467348 . This is a "KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 201329679 . This is a "TRICARE REGION 1" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 2113979 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9982794 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1939168 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 201329679 . This is a "CORESOURCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 62019601 . This is a "BLUE CROSS/BLUE SHIELD MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P00022097 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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