Provider Demographics
NPI:1104182419
Name:PHELAN, PAUL JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOHN
Last Name:PHELAN
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 1:7 BEECHDALE WAY BALLYCULLEN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:DUBLIN
Mailing Address - Zip Code:D24
Mailing Address - Country:IE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2424 ERWIN RD
Practice Address - Street 2:SUITE 605
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3824
Practice Address - Country:US
Practice Address - Phone:919-660-6860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access