Individual
THOMAS A. BLEDSOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 WAMPANOAG TRL, SUITE 201, RIVERSIDE, RI 02915-2232
(401) 649-4020
(401) 649-4021
Mailing address
17 VIRGINIA AVE, SUITE 107, PROVIDENCE, RI 02905-4406
(401) 443-4992
(401) 784-4902
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD08111
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110222755
RAILROAD MEDICARE
RI
05
—
9006673
—
RI
Enumeration date
06/01/2006
Last updated
09/12/2016
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