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1790766004

NPI Code Detail

MEDICARE: PAUL MATTHEW TELEHOWSKI MD

MEDICARE: PAUL MATTHEW TELEHOWSKI 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	4301072079	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CB0923	OTHER		GRP RAILROAD MEDICARE
6	ON45090	OTHER		GROUP MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0B51156	OTHER	MI	BLUE CROSS GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1215930490	OTHER		TYPE 2 NPI
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790766004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL MATTHEW TELEHOWSKI MD

Provider Business Mailing Address
First Line	:	4466 W BRISTOL RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-3170
Country	:	US
Telephone Number	:	810-733-1200
Fax Number	:	810-733-0688

Provider Business Practice Location Address
First Line	:	4466 W BRISTOL RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-3170
Country	:	US
Telephone Number	:	810-733-1200
Fax Number	:	810-733-0688

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	09/19/2013

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Directions to “ PAUL MATTHEW TELEHOWSKI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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