Healthcare Provider Details

I. General information

NPI: 1578722450
Provider Name (Legal Business Name): PAUL ADAM ENRIGHT LIC. ACUP.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W JEFFERSON BLVD SUITE 100
SOUTH BEND IN
46601-1994
US

IV. Provider business mailing address

26433 HILLVIEW DR
EDWARDSBURG MI
49112-9113
US

V. Phone/Fax

Practice location:
  • Phone: 574-647-2600
  • Fax: 574-239-6460
Mailing address:
  • Phone: 574-807-8157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number84000018A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: