is a General Practice in Pawtucket, Rhode Island. practices all healthcare services and medical treatments related to General Practice. The NPI Number for is 1396954640. The last update date is .
's current location address is 174 Armstice Blvd., Pawtucket, Rhode Island. You can contact this provider via phone number 4017293600. The mailing address for is 174 Armstice Blvd., Pawtucket, Rhode Island. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 174 Armstice Blvd., Pawtucket, Rhode Island |
| Phone Number | 4017293600 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1396954640 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 174 Armstice Blvd. |
|---|---|
| City | Pawtucket |
| State | Rhode Island (RI) |
| Post Code | 2860 |
| Phone Number | 4017293600 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
|
Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| MH11562 | RI | -- |
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