Provider Demographics
NPI:1427089655
Name:DOUGLASS, PAUL HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HOWARD
Last Name:DOUGLASS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:4222 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17406-8083
Practice Address - Country:US
Practice Address - Phone:717-812-7802
Practice Address - Fax:717-812-7811
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2010-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD012593E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1519364OtherGATEWAY-WMG
PA348536OtherMAMSI-WMG
PA37897OtherGEISINGER
MD524953OtherCAREFIRST MD BCBS
PA80819OtherUNISON-WMG
PA01559002OtherCAPITAL BLUE CROSS-WMG
PA1142780OtherAMERIHEALTH MERCY-WMG
PA4309133OtherAETNA
PA32658OtherJOHNS HOPKINS
PA000766280Medicaid
PA106791OtherHIGHMARK BLUE SHIELD
PA106791OtherHIGHMARK BLUE SHIELD
PAB36697Medicare UPIN
PA348536OtherMAMSI-WMG
MD524953OtherCAREFIRST MD BCBS