Provider Demographics
NPI:1144263336
Name:MANN, PAUL ATKINSON JR (MD)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ATKINSON
Last Name:MANN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:175 ELM ST.
Mailing Address - Street 2:VA CLINIC
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740
Mailing Address - Country:US
Mailing Address - Phone:508-994-0217
Mailing Address - Fax:
Practice Address - Street 1:175 ELM ST.
Practice Address - Street 2:VA CLINIC
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740
Practice Address - Country:US
Practice Address - Phone:508-994-0217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD7813207Q00000X
RIMD07813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMD7813OtherSTATE LICENSE NUMBER
E70322Medicare UPIN
089020034Medicare ID - Type Unspecified