Individual
DR. ANTHONY LE ROY MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 RANDALL SQ, STE 414, PROVIDENCE, RI 02904-2709
(401) 331-4175
(401) 331-5718
Mailing address
1 RANDALL SQ, STE 414, PROVIDENCE, RI 02904-2709
(401) 331-4175
(401) 331-5718
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
079657
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9020315
—
RI
Enumeration date
07/22/2006
Last updated
11/27/2007
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