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NPI Code Detail

MEDICARE: DAVID J. PARIS M.D.

MEDICARE: DAVID J. PARIS 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
1207Q00000XFamily Medicine Physician01039725AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3080121953OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000091885OTHERBLUE CROSS BLUE SHIELD
4000000000832OTHERMPLAN
51672OTHERPHYSICIANS HEALTH PLAN

General Provider Information

NPI Number : 1134110430
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID J. PARIS M.D.
Provider Business Mailing Address
First Line : 6920 POINTE INVERNESS WAY STE 200
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-7934
Country : US
Telephone Number : 260-479-3516
Fax Number : 260-479-3520
Provider Business Practice Location Address
First Line : 7980 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4170
Country : US
Telephone Number : 260-478-5280
Fax Number : 260-458-3536
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 10/14/2020

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Directions to “ DAVID J. PARIS M.D.” Practice Location

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