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Individual

MICHAEL JAN HULSTYN

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) 457-1530
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
(401) 457-1530

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD08456
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9020166
RI
Enumeration date
05/05/2006
Last updated
06/03/2014
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