Provider Demographics
NPI:1275663247
Name:BILDER, PAUL A (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:BILDER
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 1:55 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-2341
Mailing Address - Country:US
Mailing Address - Phone:541-255-0361
Mailing Address - Fax:541-255-0362
Practice Address - Street 1:55 S 17TH ST
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-2341
Practice Address - Country:US
Practice Address - Phone:541-255-0361
Practice Address - Fax:541-255-0362
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10106207Q00000X
OR10160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC91075Medicare UPIN
R155487Medicare PIN