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NPI Code Detail

MEDICARE: MR. STEVEN JAMES PAULISSEN MD

MEDICARE:  MR. STEVEN JAMES PAULISSEN  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 PhysicianMD17094OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1021571OTHERORDMAP/OMAP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902827827
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN JAMES PAULISSEN MD
Provider Business Mailing Address
First Line : 1234 COMMERCIAL ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-4204
Country : US
Telephone Number : 503-362-9334
Fax Number : 503-362-8016
Provider Business Practice Location Address
First Line : 1234 COMMERCIAL ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-4204
Country : US
Telephone Number : 503-362-9334
Fax Number : 503-362-8016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2006
Last Update Date : 07/28/2010

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Directions to “ MR. STEVEN JAMES PAULISSEN MD” Practice Location

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