Wortman, Paul Douglass
Wortman, Paul Douglass is an sole proprietor health care provider with primary practice located at 127 S Poplar St , Winston Salem NC 27101-3755. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Wortman, Paul Douglass can be contacted via phone (336) 893-8423.Contact Information
Primary practice address
127 S Poplar St
Winston Salem NC 27101-3755
Phone: (336) 893-8423
Fax: (336) 893-8426
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 35791 | North Carolina |
Profile Details
| NPI number | 1932108461 |
|---|---|
| LBN Legal business name | Wortman, Paul Douglass |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 18th, 2005 |
| Last updated | Jul 24th, 2019 - about 5 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 | 1932108461 | NPPES |
| Other | 0300482 | UNITED HEALTHCARE | |
| Other | P00371225 | UNITED HEALTHCARE | |
| Other | 89261 | UNITED HEALTHCARE | |
| Other | E2611 | UNITED HEALTHCARE | |
| Other | 4521 | UNITED HEALTHCARE | |
| Other | 6309395 | UNITED HEALTHCARE | |
| MEDICAID | 8989261 | UNITED HEALTHCARE | |
| Other | 5975022 | UNITED HEALTHCARE |
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