MEDICARE: DR. PAUL J NEARY 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	2080C0008X	Child Abuse Pediatrics Physician	26844-20	WI
2	208M00000X	Hospitalist Physician	26844-20	WI

General Provider Information

NPI Number	:	1508860537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL J NEARY MD

Provider Business Mailing Address
First Line	:	213 N HIGH ST
Second Line	:
City	:	FORT ATKINSON
State	:	WI
Zip	:	53538-1938
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 N HIGH ST
Second Line	:
City	:	FORT ATKINSON
State	:	WI
Zip	:	53538-1938
Country	:	US
Telephone Number	:	920-542-5028
Fax Number	:

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	09/16/2024

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