Bagdade, Paul S
Bagdade, Paul S is an sole proprietor health care provider with primary practice located at 2945 Hazelwood St Ste 200 , Maplewood MN 55109-1243. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bagdade, Paul S can be contacted via phone (612) 440-6315.Contact Information
Primary practice address
2945 Hazelwood St Ste 200
Maplewood MN 55109-1243
Phone: (612) 440-6315
Fax: (651) 471-9442
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP 4527 | Minnesota |
Profile Details
| NPI number | 1699785196 |
|---|---|
| LBN Legal business name | Bagdade, Paul S |
| Credentials | PH.D., L.P. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 8th, 2006 |
| Last updated | Oct 26th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699785196 | NPPES |
| Minnesota | Other | 519T2BA | BCBS |
| Minnesota | MEDICAID | 093464000 | BCBS |
| Minnesota | Other | HP48607 | BCBS |
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