Individual
PAUL S. MATHAROO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
Mailing address
PO BOX 2648, PIKEVILLE, KY 41502-2648
(606) 432-1357
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
45117
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000770732
ANTHEM
KY
05
—
1689835332
—
VA
05
—
7100208840
—
KY
01
—
P01077792
RAILROAD MEDICARE
KY
Enumeration date
06/24/2008
Last updated
09/29/2023
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