Individual
DR. LEE EVERETT EDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 DUDLEY, SUITE 460, PROVIDENCE, RI 02905
(401) 331-2303
(401) 331-4430
Mailing address
2 DUDLEY, SUITE 460, PROVIDENCE, RI 02905
(401) 331-2303
(401) 331-4430
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
5949
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050395339
TAX ID
RI
01
—
1300121
UNITED HEALTH
RI
01
—
300043
BLUECHIP
RI
Enumeration date
10/03/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us