Healthcare Provider Details

I. General information

NPI: 1821306911
Provider Name (Legal Business Name): PAUL R CAULEY C.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 03/31/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26850 PROVIDENCE PKWY STE 110
NOVI MI
48374-1214
US

IV. Provider business mailing address

26850 PROVIDENCE PKWY STE 110
NOVI MI
48374-1214
US

V. Phone/Fax

Practice location:
  • Phone: 248-329-0070
  • Fax: 855-350-5612
Mailing address:
  • Phone: 248-329-0070
  • Fax: 855-350-5612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: