MEDICARE: DR. PAUL A NEUMANN D.D.S.

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	1223G0001X	General Practice Dentistry	0401006687	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	033053	OTHER	VA	ANTHEM ID #

General Provider Information

NPI Number	:	1336167501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL A NEUMANN D.D.S.

Provider Business Mailing Address
First Line	:	204 N HAMILTON ST
Second Line	:	SUITE ONE
City	:	RICHMOND
State	:	VA
Zip	:	23221-2662
Country	:	US
Telephone Number	:	804-358-4089
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 N HAMILTON ST
Second Line	:	SUITE ONE
City	:	RICHMOND
State	:	VA
Zip	:	23221-2662
Country	:	US
Telephone Number	:	804-358-4089
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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