Organization
PAULETTE MOULTON-LEVY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULETTE P MOULTON M.D. (OWNER)
(734) 241-4950
Entity
Organization
Contact information
Practice address
2246 N MONROE ST, MONROE, MI 48162-4254
(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
174400000X
Specialist
Primary
4301042774
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0705810191
BCBS
MI
05
—
1437615
—
MI
Enumeration date
04/04/2007
Last updated
08/22/2020
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