Individual
MICHELLE C. VANNIEUWENHUIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6 BLACKSTONE VALLEY PL, BUILDING #3 SUITE 305, LINCOLN, RI 02865-1179
(401) 334-1097
(401) 305-5497
Mailing address
6 BLACKSTONE VALLEY PL, BUILDING #3 SUITE 305, LINCOLN, RI 02865-1179
(401) 334-1097
(401) 305-5497
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD11885
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29892-8
BLUE CROSS
RI
01
—
412860
BLUE CHIP
RI
Enumeration date
08/07/2006
Last updated
11/18/2014
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