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Individual

RICHARD DOUGLAS PAUL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1215 PLEASANT ST, SUITE 400, DES MOINES, IA 50309-1416
(515) 241-5722
(515) 241-4403
Mailing address
7955 26 WISTFUL VISTA DRIVE, WEST DES MOINES, IA 50266
(515) 537-9456

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
18423
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0085266
IA
01
08526
BLUE SHIELD PROVIDER #
IA
01
18423
TRICARE PROVIDER #
IA
01
4264
MIDLANDS PROVIDER #
IA
01
IA0119
JOHN DEERE PROVIDER #
IA
Enumeration date
12/22/2005
Last updated
07/09/2007
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