Provider Demographics
NPI:1386615615
Name:HUNTZINGER, PAUL EVAN (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:EVAN
Last Name:HUNTZINGER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USCG HQ, COMDT (CG-1122)
Mailing Address - Street 2:2100 2ND ST, RM 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USCG HQ, COMDT (CG-1122)
Practice Address - Street 2:2100 2ND ST, RM 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:202-267-0694
Practice Address - Fax:202-267-4685
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44650183500000X
TX31694183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist