Individual
MRS. STEFANIE ANN PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7950 W JEFFERSON BLVD STE 210, FORT WAYNE, IN 46804
(260) 435-7355
(260) 435-7637
Mailing address
3401 CIVIC CENTER BLVD STE M975, PHILADELPHIA, PA 19104-4319
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01080261A
IN
208000000X
Pediatrics Physician
Primary
MD479770
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2015
Last updated
02/25/2023
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