Individual
PAUL D. FADALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 DUDLEY ST, STE 200, PROVIDENCE, RI 02905-3236
(401) 457-1535
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
(401) 457-1535
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
06744
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000399
—
RI
Enumeration date
05/30/2006
Last updated
06/03/2014
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