Provider Demographics
NPI:1538149299
Name:PARIS, MICHAEL J (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:PARIS
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:250 FAME AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1587
Mailing Address - Country:US
Mailing Address - Phone:717-632-5264
Mailing Address - Fax:717-632-1165
Practice Address - Street 1:250 FAME AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1587
Practice Address - Country:US
Practice Address - Phone:717-632-5264
Practice Address - Fax:717-632-1165
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC004734L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY201329679OtherHEALTH ASSURANCE/AMERICA
PA1467348OtherFEDERAL BCBS
PA1960648002OtherMEDICAL ASSISTANCE
PA201329679OtherSOUTH CENTRAL PREFERRED
PA50038811OtherCAPITAL BLUE CROSS
MD2113979OtherOPTIMUM CHOICE
MD2113979OtherALLIANCE
DCJ902OtherCAPITAL BCBS OF DC
PA1467348OtherAMERIHEALTH ADMINISTRATOR
PA1467348OtherKEYSTONE
SC201329679OtherTRICARE REGION 1
MD2113979OtherMAMSI
PA9982794OtherCIGNA HEALTHCARE
PA1939168OtherHIGHMARK
PA201329679OtherCORESOURCE
MD62019601OtherBLUE CROSS/BLUE SHIELD MD
GAP00022097OtherMEDICARE RAILROAD
DCJ902OtherCAPITAL BCBS OF DC
PA201329679OtherCORESOURCE
U94855Medicare UPIN