Individual
MICHAEL A DOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906
(401) 793-4102
(401) 793-4049
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00457
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004250586
—
CT
01
—
00425058600
EDS BLUE CARE
—
01
—
102000
CT
—
01
—
290000201CT
ANTHEM
—
01
—
P3591308
OXFORD
—
Enumeration date
08/18/2006
Last updated
04/08/2019
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