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General NPI Number Information
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NPI Number | 1003027202
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Entity Type | Individual
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Provider Name | PAUL GASTON DEL VALLE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2007
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 1320 W MAIN ST
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City | NEWARK
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State | OH
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Zip | 43055-1822
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Country | US
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Telephone | 740-348-4318
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Fax | 740-348-4217
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Provider Business Mailing Address
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Address Line | 860 E BROAD ST STE I
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City | ELYRIA
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State | OH
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Zip | 44035-6542
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Country | US
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Telephone | 740-348-4318
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Fax | 740-348-4217
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35.089044
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 82167
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 35.089044
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 41045
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 82167
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD41045
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License Number State | SC
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