Individual
MONIQUE L. POULIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
481 KINGSTOWN RD, WAKEFIELD, RI 02879-3626
(401) 789-0283
(401) 789-0314
Mailing address
481 KINGSTOWN RD, WAKEFIELD, RI 02879-3626
(401) 789-0283
(401) 789-0314
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO00431
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0402439
UNITEDHEALTHCARE
RI
01
—
204786
BLUE CHIP HMORI
RI
05
—
7006057
—
RI
01
—
DO00431
STATE LICENSE
RI
01
—
RI431
BLUE CROSS LICENSE
RI
Enumeration date
06/07/2006
Last updated
06/15/2010
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