Provider Demographics
NPI:1700371960
Name:PAUL, DEBORAH (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CENTRAL ST UNIT 492
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-7024
Mailing Address - Country:US
Mailing Address - Phone:330-230-0262
Mailing Address - Fax:
Practice Address - Street 1:8183 GOLDEN LINK BLVD
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44067-2015
Practice Address - Country:US
Practice Address - Phone:330-778-1278
Practice Address - Fax:330-525-9009
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176004207N00000X
MN71417207ND0101X
OH35.152280207ND0101X
MA295603207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110199508AMedicaid