Healthcare Provider Details

I. General information

NPI: 1619058880
Provider Name (Legal Business Name): EDWARD G PAUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W TAMARISK ST
PHOENIX AZ
85041-2422
US

IV. Provider business mailing address

8088 W WHITNEY DR
PEORIA AZ
85345-6564
US

V. Phone/Fax

Practice location:
  • Phone: 833-855-9973
  • Fax: 602-655-9660
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number33100
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33100
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: