NPIMap

Organization Active NPI

Paula E Bourelly MD & Assoc

Doing business as Olney Dermatology Associates

  • Dermatology Physician
  • Olney, MD
National Provider Identifier
1710157086
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D0052140 Issued in MD
Legal business name
PAULA E BOURELLY MD & ASSOC
Doing business as
Olney Dermatology Associates
Practice address
18111 Prince Philip Dr
Suite123
Olney, MD 20832-1513
Phone
(301) 260-9202
Fax
(301) 260-9201
NPI assigned
Mar 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paula Elise Bourelly, M.D.NPI 1700884855
Title
Physician
Phone
(301) 260-9202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X D0052140 MD Primary

Addresses

Primary practice location

18111 Prince Philip Dr
Suite123
Olney, MD 20832-1513

Mailing address

18111 Prince Philip Dr
Suite123
Olney, MD 20832-1513
Phone (301) 260-9202

Other names 1

  • Olney Dermatology Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1710157086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "SUITE123",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321513",
            "telephone_number": "301-260-9202",
            "fax_number": "301-260-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "SUITE123",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321513",
            "telephone_number": "301-260-9202",
            "fax_number": "301-260-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULA E BOURELLY MD & ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "BOURELLY",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "301-260-9202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0052140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olney Dermatology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olney, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.