Organization
SHOELINE SURGICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID COPPE M.D. (PRESIDENT)
(401) 284-4114
Entity
Organization
Contact information
Practice address
70 KENYON AVE UNIT 325, WAKEFIELD, RI 02879-4253
(401) 284-4114
(401) 789-1358
Mailing address
70 KENYON AVE UNIT 325, WAKEFIELD, RI 02879-4253
(401) 284-4114
(401) 789-1358
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RI6307
RI
Other
Enumeration date
09/15/2006
Last updated
08/22/2020
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