Individual
PAULETTE MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2246 N MONROE ST, MONROE, MI 48162
(734) 241-4950
(734) 243-4269
Mailing address
PO BOX 2503, MONROE, MI 48161-7503
(734) 241-4950
(734) 243-4269
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301042274
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0705810691
BCBS OF MICHIGAN
MI
05
—
4893843
—
MI
Enumeration date
01/08/2007
Last updated
07/27/2018
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