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Individual
MR. PAUL FREDRICK SPECKART
Active
Individual
MR. PAUL FREDRICK SPECKART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, M.F.A.C.P.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C31776
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C317660
BLUE SHIELD
CA
05
—
00C317760
—
CA
01
—
31776
HMO
CA
01
—
92585978
CHAMPUS
CA
01
—
C31776
BLUE CROSS
CA
Enumeration date
10/04/2006
Last updated
02/01/2012
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