Individual
MR. DOUGLAS BRUCE GENEREUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
70 KENYON AVE STE 280, WAKEFIELD, RI 02879-4253
(401) 284-1212
(401) 788-8730
Mailing address
PO BOX 229, WAKEFIELD, RI 02880-0229
(401) 788-3929
(401) 788-3939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
199
RI
363A00000X
Physician Assistant
Primary
PA00199
RI
363AS0400X
Surgical Physician Assistant
PA00199
RI
Other
Enumeration date
10/19/2006
Last updated
01/12/2026
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