Individual
DR. FADI MANSOURATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
886 MINERAL SPRING AVE, PAWTUCKET, RI 02860-3322
(401) 475-3063
(401) 475-0593
Mailing address
886 MINERAL SPRING AVE, PAWTUCKET, RI 02860-3322
(401) 475-3063
(401) 475-0593
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD09843
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006714
—
RI
Enumeration date
12/08/2005
Last updated
06/07/2012
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