Healthcare Provider Details

I. General information

NPI: 1568564003
Provider Name (Legal Business Name): PAUL KULPINSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 03/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 S PACA ST LOWER LEVEL
BALTIMORE MD
21201-1771
US

IV. Provider business mailing address

PO BOX 64380
BALTIMORE MD
21264-4380
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-5145
  • Fax: 410-328-8726
Mailing address:
  • Phone: 410-328-5145
  • Fax: 410-328-8726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD52866
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberD52866
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: