Provider Demographics
NPI:1093779795
Name:STEINWACHS, PAUL RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:RICHARD
Last Name:STEINWACHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2114
Mailing Address - Country:US
Mailing Address - Phone:706-221-2401
Mailing Address - Fax:706-221-2364
Practice Address - Street 1:1336 3RD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2114
Practice Address - Country:US
Practice Address - Phone:706-221-2401
Practice Address - Fax:706-221-2364
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042736208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00833093DMedicaid