Organization
SOUTH COUNTY FAMILY MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN BERTMAN M.D (CEO)
(401) 539-0283
Entity
Organization
Contact information
Practice address
1111 MAIN ST, HOPE VALLEY, RI 02832-1610
(401) 539-0283
(401) 539-6741
Mailing address
1111 MAIN ST, HOPE VALLEY, RI 02832-1610
(401) 539-0283
(401) 539-6741
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RI8814
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SC42150
—
RI
Enumeration date
08/14/2006
Last updated
03/02/2011
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