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Individual

WILLIAM LEWANDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 854-2504
(401) 854-2519
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD06604
RI
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
MD06604
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10/02/2009
NHPRI
RI
01
12/29/2008
TUFTS
RI
01
1245244458
NPI
RI
05
3184749
MA
05
7000126
RI
01
939025129
RI MEDICARE GROUP NUMBER
RI
Enumeration date
07/27/2006
Last updated
09/18/2013
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