Individual
STEPHEN E. PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
111 E MAIN ST, MAPLE SHADE, NJ 08052-2679
(856) 779-9220
(856) 779-7890
Mailing address
111 E MAIN ST, MAPLE SHADE, NJ 08052-2679
(856) 779-9220
(856) 779-7890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB02548900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080169223
RAILROAD MEDICARE
NJ
05
—
2433109
—
NJ
Enumeration date
07/05/2005
Last updated
08/13/2008
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