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Individual

ROBERT CARRELLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
674 AQUIDNECK AVE, MIDDLETOWN, RI 02842-5692
(401) 847-9955
(401) 847-9948
Mailing address
674 AQUIDNECK AVE, MIDDLETOWN, RI 02842-5692

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8200
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7002857
RI
Enumeration date
11/14/2007
Last updated
05/08/2009
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