Individual
DR. PAUL M POPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21229 OLEAN BLVD, SUITE D, PORT CHARLOTTE, FL 33952-6719
(941) 625-6223
(941) 627-2680
Mailing address
21229 OLEAN BLVD, SUITE D, PORT CHARLOTTE, FL 33952-6719
(941) 625-6223
(941) 627-2680
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME-0046549
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046745600
—
FL
01
—
060012033
RAILROAD MEDICARE
—
01
—
08148
BLUE SHIELD
—
01
—
1838539001
CIGNA
—
01
—
2101033
GHI
—
01
—
278926
WELLCARE
—
01
—
592171328-002
TRICARE/CHAMPUS
—
01
—
5930135
AETNA
—
Enumeration date
07/16/2006
Last updated
07/16/2015
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