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NPI Code Detail

MEDICARE: PAUL ETHAN AUSTIN M.D.

MEDICARE: PAUL ETHAN AUSTIN M.D.
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
1207Q00000XFamily Medicine Physician35094NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
212210OTHERNCBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1467427823
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL ETHAN AUSTIN M.D.
Provider Business Mailing Address
First Line : 1301 FAYETTEVILLE ST
Second Line :
City : DURHAM
State : NC
Zip : 27707-2325
Country : US
Telephone Number : 919-956-4000
Fax Number : 919-667-2322
Provider Business Practice Location Address
First Line : 1301 FAYETTEVILLE ST
Second Line :
City : DURHAM
State : NC
Zip : 27707-2325
Country : US
Telephone Number : 919-956-4000
Fax Number : 919-667-2322
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 02/28/2017

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