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Individual

DR. PAUL D LIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-5720
(410) 328-5685
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-5720
(410) 328-5685

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D17522
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0178398001
WV
05
034369400
DC
05
150021000
MD
05
1982643250
DE
01
330480-01
BLUE CROSS/BLUE SHIELD
MD
05
8183201
NJ
Enumeration date
06/05/2006
Last updated
11/29/2010
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