Provider Demographics
NPI:1437195336
Name:ENTLER, PAUL M (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:ENTLER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1540 LAKE LANSING RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3757
Mailing Address - Country:US
Mailing Address - Phone:517-913-3900
Mailing Address - Fax:517-913-3901
Practice Address - Street 1:1540 LAKE LANSING RD STE 201
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3757
Practice Address - Country:US
Practice Address - Phone:517-913-3900
Practice Address - Fax:517-913-3901
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2009-09-22
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Provider Licenses
StateLicense IDTaxonomies
MI5101015921207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1024579OtherMCLAREN HEALTH ADVANTAGE
MI1153311954OtherBLUE CARE NETWORK
MI200000006950OtherPHP FAMILYCARE
MI1024579OtherMCLAREN HEALTH PLAN-MEDICAID
MI200000006950OtherPHP
MIP00368806OtherRAILROAD MEDICARE
MI0M21440058OtherMEDICARE PLUS BLUE
MI1153311954OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI4958527Medicaid
MI1024579OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI1024579OtherMCLAREN HEALTH PLAN-COMMERCIAL
MIM21440058Medicare PIN