MEDICARE: DR. PAUL BACHWITT MD

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	207X00000X	Orthopaedic Surgery Physician	11859	WV

General Provider Information

NPI Number	:	1083780373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL BACHWITT MD

Provider Business Mailing Address
First Line	:	10 COURTNEY DRIVE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-2699
Country	:	US
Telephone Number	:	304-925-3580
Fax Number	:	304-925-3710

Provider Business Practice Location Address
First Line	:	10 COURTNEY DRIVE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-2699
Country	:	US
Telephone Number	:	304-925-3580
Fax Number	:	304-925-3710

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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