Provider Demographics
NPI: | 1427012889 |
---|---|
Name: | LAPRISE, PAUL (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | PAUL |
Middle Name: | |
Last Name: | LAPRISE |
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: | 1 MEDICAL CENTER DR |
Mailing Address - Street 2: | |
Mailing Address - City: | BIDDEFORD |
Mailing Address - State: | ME |
Mailing Address - Zip Code: | 04005-9422 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 207-282-9080 |
Mailing Address - Fax: | 207-282-9180 |
Practice Address - Street 1: | 30 W COLE RD |
Practice Address - Street 2: | |
Practice Address - City: | BIDDEFORD |
Practice Address - State: | ME |
Practice Address - Zip Code: | 04005-9458 |
Practice Address - Country: | US |
Practice Address - Phone: | 207-282-3349 |
Practice Address - Fax: | 207-282-6099 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-04-13 |
Last Update Date: | 2012-09-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
ME | 013276 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
ME | 017205 | Other | ANTHEM |
ME | 1041791 | Other | AETNA |
ME | 246370099 | Medicaid | |
ME | F25434 | Other | HARVARD PILGRIM |
ME | M10001902 | Other | CIGNA |
ME | F25434 | Other | HARVARD PILGRIM |
ME | 017205 | Other | ANTHEM |
ME | 1041791 | Other | AETNA |