Individual
MR. RENALD ROUILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
1 AYERS CIR, BLDG H-1, PORTSMOUTH, NH 03801-3892
(207) 438-1130
(207) 438-2438
Mailing address
43 SMITH RD, ATTN: PROFESSIONAL AFFAIRS, NEWPORT, RI 02841-1002
(401) 841-4522
(401) 841-4128
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1005728
—
Other
Enumeration date
12/13/2005
Last updated
11/07/2007
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