Provider Demographics
NPI:1366438053
Name:MONROE, PAUL S (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:S
Last Name:MONROE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2369 STAPLES MILL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-2918
Mailing Address - Country:US
Mailing Address - Phone:804-285-4465
Mailing Address - Fax:804-285-8332
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 706
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1926
Practice Address - Country:US
Practice Address - Phone:804-285-8206
Practice Address - Fax:804-285-0162
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-05-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101031995207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006014259Medicaid
100000006Medicare PIN
VA006014259Medicaid