MEDICARE: DR. PAUL J DRIVER M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MA06287800	NJ
2	207W00000X	Ophthalmology Physician	MD055909L	PA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01000740700	OTHER	NJ	AMERICHOICE NJ
2	0160949806	OTHER	PA	AMERICHOICE PA
3	0827762000	OTHER	NJ	AMERIHEALTH
4	232246884	OTHER	PA	HEALTH PARTNERS
5	0160949807	OTHER	PA	AMERICHOICE PA
6	0620133	OTHER	NJ	AETNA HMO
7	3Y4954	OTHER	PA	HEALTH NET
8	5236407	OTHER	PA	AETNA PPO
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	535526	OTHER	PA	AETNA HMO
11	9635	OTHER	PA	ELDER HEALTH
12	0160949805	OTHER	PA	AMERICHOICE PA
13	2K4019	OTHER	NJ	HEALTH NET
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	5236407	OTHER	NJ	AETNA PPO
16	8325714	OTHER	PA	CIGNA
17	8325714	OTHER	NJ	CIGNA

NPI Number	:	1477550002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL J DRIVER M.D.

Provider Business Mailing Address
First Line	:	5001 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-2619
Country	:	US
Telephone Number	:	215-288-5000
Fax Number	:	215-744-1233

Provider Business Practice Location Address
First Line	:	5001 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-2619
Country	:	US
Telephone Number	:	215-288-5000
Fax Number	:	215-744-1233

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	02/07/2008