Individual
PAUL DOUGLAS WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1975 GLENN MITCHELL DR, SUITE #200, VIRGINIA BEACH, VA 23456-0167
(757) 321-3383
(757) 321-3332
Mailing address
230 CLEARFIELD AVE., SUITE # 124, VIRGINIA BEACH, VA 23462-1832
(757) 321-3383
(757) 321-3332
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101058667
VA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
0101058667
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006401490
—
VA
01
—
200040146
RAILROAD MEDICARE
—
01
—
C05501
MEDICARE GROUP
VA
01
—
CC7688
RAILROAD MEDICARE GROUP#
—
Enumeration date
01/03/2006
Last updated
09/17/2015
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