Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 83031 | OH |
NPI | 1003839275 |
---|---|
Provider Name | Dr. Douglas Edward Paull |
First Address | Dayton, OH 45428-9000 |
Second Address | Dayton, OH 45428-9000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |