Provider Demographics
NPI:1306966593
Name:PAUL M. APOSTOLO MD.PA
Entity type:Organization
Organization Name:PAUL M. APOSTOLO MD.PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:APOSTOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-368-4851
Mailing Address - Street 1:3449 WILKENS AVE
Mailing Address - Street 2:SUITE #205
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5281
Mailing Address - Country:US
Mailing Address - Phone:410-368-4851
Mailing Address - Fax:
Practice Address - Street 1:3449 WILKENS AVE
Practice Address - Street 2:SUITE #205
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5281
Practice Address - Country:US
Practice Address - Phone:410-368-4851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD38326174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD146863600OtherDEPT OF LABOR
MDR118 0001OtherBCBS
MD03732011OtherUNITED HEALTHCARE
MD42406002OtherMD POINT OF SERVICE PPN
MD4288612OtherAETNA
MD533391100Medicaid
MDD38326OtherSTATE LICENSE
MD200013205OtherRAILROAD MEDICARE
MD2329433OtherAETNA
MD314506OtherMAMSI UNITED HEALTHCARE
MD314506OtherMAMSI UNITED HEALTHCARE
MD03732011OtherUNITED HEALTHCARE
MD2329433OtherAETNA