MEDICARE: MICHAEL K PAUL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	4301406658	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053387035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL K PAUL M.D.

Provider Business Mailing Address
First Line	:	1221 PINE GROVE AVE
Second Line	:	MCLAREN PORT HURON - EMERGENCY MEDICINE DEPARTMENT
City	:	PORT HURON
State	:	MI
Zip	:	48060-3511
Country	:	US
Telephone Number	:	810-989-3300
Fax Number	:	810-985-2671

Provider Business Practice Location Address
First Line	:	1221 PINE GROVE AVE
Second Line	:	MCLAREN PORT HURON - EMERGENCY MEDICINE DEPARTMENT
City	:	PORT HURON
State	:	MI
Zip	:	48060-3511
Country	:	US
Telephone Number	:	810-989-3300
Fax Number	:	810-985-2671

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	09/04/2014

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