Individual
DONALD R COUSTAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 DUDLEY ST, PROVIDENCE, RI 02905-2401
(401) 274-1122
(401) 453-7599
Mailing address
101 DUDLEY ST, PROVIDENCE, RI 02905-2401
(401) 274-1122
(401) 453-7599
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6028
RI
207VM0101X
Maternal & Fetal Medicine Physician
6028
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003805
—
RI
Enumeration date
12/02/2005
Last updated
09/11/2025
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