Provider Demographics
NPI:1316652753
Name:ANTONY, PAUL ANDREW
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ANDREW
Last Name:ANTONY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10942 RAMPART WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4765
Mailing Address - Country:US
Mailing Address - Phone:202-320-6085
Mailing Address - Fax:
Practice Address - Street 1:10942 RAMPART WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4765
Practice Address - Country:US
Practice Address - Phone:202-320-6085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No174400000XOther Service ProvidersSpecialist