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Individual
CARLOS H NIETO
Active
Individual
CARLOS H NIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
04725
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2279-4
RI BLUE CROSS
RI
Enumeration date
06/19/2006
Last updated
11/25/2008
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