Individual
PAUL V BULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027
(262) 670-4000
(262) 670-4451
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41040
WI
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
41040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32557200
—
WI
01
—
P00941428
RR MEDICARE
WY
Enumeration date
08/05/2006
Last updated
11/29/2021
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