Individual
SAMUEL EDWIN DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 BREWSTER ST, PAWTUCKET, RI 02860
(401) 729-2304
Mailing address
304 SCHOOL ST, WATERTOWN, MA 02472-1415
(617) 549-4262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LP04395
RI
Other
Enumeration date
03/30/2018
Last updated
07/06/2018
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