Healthcare Provider Details

I. General information

NPI: 1114092962
Provider Name (Legal Business Name): PAUL DAVID MEHLHOP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 HEMBY LN.
GREENVILLE NC
27834
US

IV. Provider business mailing address

2395 HEMBY LN.
GREENVILLE NC
27834
US

V. Phone/Fax

Practice location:
  • Phone: 252-321-8683
  • Fax: 252-329-8686
Mailing address:
  • Phone: 252-321-8683
  • Fax: 252-329-8686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number980095
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number980095
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: