Provider Demographics
NPI:1124285127
Name:PAUL, RICHARD ALAN (MD)
Entity type:Individual
Prefix:PROF
First Name:RICHARD
Middle Name:ALAN
Last Name:PAUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6090 26TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-4401
Mailing Address - Country:US
Mailing Address - Phone:941-218-2353
Mailing Address - Fax:844-388-6186
Practice Address - Street 1:6090 26TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207
Practice Address - Country:US
Practice Address - Phone:941-218-2353
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine