Healthcare Provider Details

I. General information

NPI: 1649272071
Provider Name (Legal Business Name): PAUL WILLIAM SAUERS DO, LACC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 BIANCA AVE
CARNEYS POINT NJ
08069-2633
US

IV. Provider business mailing address

298 BIANCA AVE
CARNEYS POINT NJ
08069-2633
US

V. Phone/Fax

Practice location:
  • Phone: 856-299-0002
  • Fax: 856-299-6169
Mailing address:
  • Phone: 856-299-0002
  • Fax: 856-299-6169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MB2592900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: