Male or Other

Paul L. Wasserman DO

Diagnostic Radiology Physician in Palm Coast, FL(View on Map)

Full Name

Paul Louis Wasserman DO

NPI Number

1699701011

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/25/2006

Specialties

(Taxonomies)

Licenses

State

Florida
Florida
North Carolina

License Number

OS11113
OS1113
2004-00278

Contact
Information

Purpose

Mailing
Location

Address

60 MEMORIAL MEDICAL PKWY
60 MEMORIAL MEDICAL PKWY

City

Palm Coast
Palm Coast

State

FL
FL

Postal Code

32164-5980
32164-5980

Country

US
US

Telephone Number

(386) 586-2000
(386) 586-2000

Identifiers

Identifier

189353
2038722D
7547722
Q0027M
805973
5901625
139NM
3810008229
P00367349

Identifier State

Unknown
NC
Unknown
SC
Unknown
NC
Unknown
WV
Unknown

Identifier Issuer

MEDCOST
MEDICARE
AETNA
Unknown
PARTNERS
Unknown
BCBS
Unknown
RR MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/07/2022

Provider Address

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