Basic Information
| Provider Information | |||||||||
| NPI: | 1568409423 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARADIS | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | Y | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 LLOYD ST | ||||||||
| Address2: | CARRBORO COMMUNITY HEALTH CENTER | ||||||||
| City: | CARRBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275101823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199428741 | ||||||||
| FaxNumber: | 9199421473 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 LLOYD ST | ||||||||
| Address2: | CARRBORO COMMUNITY HEALTH CENTER | ||||||||
| City: | CARRBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275101823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199428741 | ||||||||
| FaxNumber: | 9199421473 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 09/03/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 98-01432 | NC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 12563 | 01 | NC | BC/BS IND PROV NO | OTHER | 8912563 | 05 | NC | MEDICAID |