Wasserman, Paul Louis
Wasserman, Paul Louis is an individual health care provider with primary practice located at 60 Memorial Medical Pkwy , Palm Coast FL 32164-5980. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Wasserman, Paul Louis can be contacted via phone (386) 586-2000.Contact Information
Primary practice address
60 Memorial Medical Pkwy
Palm Coast FL 32164-5980
Phone: (386) 586-2000
Fax: (317) 705-5047
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 2004-00278 | North Carolina |
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | OS1113 | Florida |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 2004-00278 | North Carolina |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | OS11113 | Florida |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 2004-00278 | North Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | OS11113 | Florida |
Profile Details
| NPI number | 1699701011 |
|---|---|
| LBN Legal business name | Wasserman, Paul Louis |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2006 |
| Last updated | Sep 7th, 2022 - about 2 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 | 1699701011 | NPPES |
| Other | 189353 | MEDCOST | |
| Other | 2038722D | MEDCOST | |
| Other | 7547722 | MEDCOST | |
| MEDICAID | Q0027M | MEDCOST | |
| Other | 805973 | MEDCOST | |
| MEDICAID | 5901625 | MEDCOST | |
| Other | 139NM | MEDCOST | |
| MEDICAID | 3810008229 | MEDCOST | |
| Other | P00367349 | MEDCOST |
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