MEDICARE: PAUL B SYTMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD00030642	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110080961	OTHER	WA	PALMETTO RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	43551	OTHER	WA	LABOR & INDUSTRY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	SY4236	OTHER	WA	REGENCE
5	3679SY	OTHER	WA	REGENCE

General Provider Information

NPI Number	:	1134116627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL B SYTMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 3489
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98114-3489
Country	:	US
Telephone Number	:	206-386-9500
Fax Number	:	206-357-6380

Provider Business Practice Location Address
First Line	:	3236 78TH AVE SE
Second Line	:	SUITE 200
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-3500
Country	:	US
Telephone Number	:	206-275-5060
Fax Number	:	206-275-5061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	10/09/2020

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Directions to “ PAUL B SYTMAN MD” Practice Location

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