Organization
COASTAL MEDICAL INC
Active
Organization
COASTAL MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERYL MOSS (COO)
(401) 421-4000
Entity
Organization
Contact information
Practice address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 453-3258
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 453-3258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM13413
—
RI
Enumeration date
10/03/2005
Last updated
04/01/2016
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