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NPI Code Detail

MEDICARE: PAUL AUGUSTINE MD

MEDICARE:   PAUL  AUGUSTINE  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
1207R00000XInternal Medicine Physician0101223331VA

General Provider Information

NPI Number : 1659359230
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL AUGUSTINE MD
Provider Business Mailing Address
First Line : PO BOX 1239
Second Line :
City : TROY
State : MI
Zip : 48099-1239
Country : US
Telephone Number : 248-824-6600
Fax Number : 248-324-1477
Provider Business Practice Location Address
First Line : 7447 CENTRAL BUSINESS PARK DR
Second Line : SUITE 104
City : NORFOLK
State : VA
Zip : 23513-2831
Country : US
Telephone Number : 757-853-1380
Fax Number : 757-282-4550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 08/28/2012

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