Provider Demographics
NPI:1316468986
Name:DI PAOLA, SEAN GREGORY (PA)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:GREGORY
Last Name:DI PAOLA
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 5607
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5607
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:550 N HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4910
Practice Address - Country:US
Practice Address - Phone:316-962-2239
Practice Address - Fax:316-962-2668
Is Sole Proprietor?:No
Enumeration Date:2017-07-04
Last Update Date:2017-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical