Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101266352 | VA |
N | 111NI0900X | Internist | 0101266352 | VA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 0101266352 | VA |
N | 207RC0000X | Internist - Cardiovascular Disease | 2013006631 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | ME74804 | FL |
NPI | 1003823329 |
---|---|
Provider Name | Dr. Daniel Frank Pauly |
First Address | Roanoke, VA 24014-2465 |
Second Address | Roanoke, VA 24014-2465 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 13/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003823329 | (05) | MO |
254079700 | (05) | FL |
G63870 | (02) |