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Individual

PAULA PROVINCE WARREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
301 S 28TH AVE, HATTIESBURG, MS 39401-7233
(601) 261-1700
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-1700
(601) 579-5240

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
25817
MS
2084N0400X
Neurology Physician
Primary
25817
MS
2084N0400X
Neurology Physician
MD.30689
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00882767
MS
Enumeration date
06/12/2009
Last updated
06/08/2022
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