Healthcare Provider Details

I. General information

NPI: 1700873940
Provider Name (Legal Business Name): PAUL HENRY JUENGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 ARROWHEAD BLVD STE 210
MEBANE NC
27302-7637
US

IV. Provider business mailing address

PO BOX 2
BURLINGTON NC
27216-0002
US

V. Phone/Fax

Practice location:
  • Phone: 919-563-9705
  • Fax: 919-304-0057
Mailing address:
  • Phone: 336-226-0660
  • Fax: 336-227-6327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number30050
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: