Provider Demographics
NPI:1396432910
Name:FIELDS, PAUL JOSEPH
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:JOSEPH
Last Name:FIELDS
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 1:1201 W MOUNT ROYAL AVE UNIT 350
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-4586
Mailing Address - Country:US
Mailing Address - Phone:314-578-6548
Mailing Address - Fax:
Practice Address - Street 1:1201 W MOUNT ROYAL AVE UNIT 350
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-4586
Practice Address - Country:US
Practice Address - Phone:314-578-6548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training Provider