Individual
DR. MICHAEL CHARLES NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 WELLS ST, WESTERLY, RI 02891-2922
(860) 415-9248
(860) 415-9237
Mailing address
PO BOX 609, LEDYARD, CT 06339-0609
(860) 415-9248
(860) 415-9237
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD10818
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7009817
—
RI
01
—
MD10818
STATE RI LICENSE
RI
Enumeration date
01/20/2006
Last updated
03/07/2023
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