Individual
LAUREN MICHAL DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
41 SANDERSON RD, SUITE 201, SMITHFIELD, RI 02917-2602
(401) 949-0300
(401) 349-3387
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD14240
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003413601
MEDICARE PTAN
—
01
—
709004048
MEDICARE GROUP
—
05
—
LD93741
—
RI
Enumeration date
05/11/2010
Last updated
01/23/2014
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