Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 5101012057 | MI |
N | 207QA0505X | Family Doctor - Adult Medicine | 5101012057 | MI |
NPI | 1841285467 |
---|---|
Provider Name | Dr. Joseph Thomas Paupore |
First Address | Livonia, MI 48152-1754 |
Second Address | Livonia, MI 48152-1754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10920041 | CIGNA PROVIDER ID (01) | MI |
16325 | MCARE ID (01) | MI |
4506903 | (05) | MI |
5446534 | AETNA ID (01) | MI |
5821017 | BCBS PIN (01) | MI |
F98611 | (02) | MI |