Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 111058 | AK |
Y | 207T00000X | Neurosurgeon | AK111058 | AK |
NPI | 1073771481 |
---|---|
Provider Name | Dr. David Paul Paulson |
First Address | Anchorage, AK 99511-0909 |
Second Address | Anchorage, AK 99508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 08/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1670001 | (05) | AK |