| Doctor Name: | DR. PAUL D SHALES |
| NPI Number: | 1811976848 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 23760 |
| Business Practice Address: | Psc 819 Box 50 Fpo, AE - 09645-0050 |
| Business Phone Number: | 34956824029 |
| Business Fax Number: | 34956824032 |
| Mailing Address: | Psc 819, Box 50 FPO |
| State: | AE |
| Postal Code: | 09645-0050 |
| Phone Number: | 34956824029 |
| Fax Number: | 34956824032 |
| NPI Enumeration Date: | 01/10/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | 23760 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |