Individual
BERNARD A MOULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 VETERANS MEMORIAL PKWY, BUILDING 14, E PROVIDENCE, RI 02914-5300
(401) 435-6600
Mailing address
281 WICKFORD POINT RD, N KINGSTOWN, RI 02852-4050
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD05366
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20355
BLUE SHIELD
RI
05
—
9020355
—
RI
Enumeration date
08/31/2006
Last updated
02/20/2009
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