Provider Demographics
NPI:1366401515
Name:EDER, PAUL A (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:EDER
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 1:200 E 33RD ST
Mailing Address - Street 2:SUITE 640
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3322
Mailing Address - Country:US
Mailing Address - Phone:410-366-4441
Mailing Address - Fax:410-243-7532
Practice Address - Street 1:200 E 33RD ST
Practice Address - Street 2:SUITE 640
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3322
Practice Address - Country:US
Practice Address - Phone:410-366-4441
Practice Address - Fax:410-243-7532
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038282207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD440003475OtherRAILROAD MEDICARE #
MD557271100Medicaid
MDE718OtherBLUECHOICE #
MDLS78INOtherCAREFIRST
MD440003475OtherRAILROAD MEDICARE #
MD307RMedicare PIN