Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 35.089044 | OH |
N | 207L00000X | Anesthesiologist | 82167 | GA |
Y | 207L00000X | Anesthesiologist | MD41045 | SC |
NPI | 1003027202 |
---|---|
Provider Name | Dr. Paul Gaston Del Valle |
First Address | Elyria, OH 44035-6542 |
Second Address | Newark, OH 43055-1822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2007 |
Last Update Date | 04/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000598891 | ANTHEM (01) | OH |
1003027202 | NPI (01) | OH |
2951257 | (05) | OH |