Individual
MICHAEL C COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1950 TOWER HILL RD, NORTH KINGSTOWN, RI 02852-6639
(401) 559-3954
(401) 294-4116
Mailing address
1950 TOWER HILL RD, NORTH KINGSTOWN, RI 02852-6639
(401) 559-3954
(401) 294-4116
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
MD08308
RI
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
MD08308
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005185
BCBSRI/CHIP
RI
05
—
7004684
—
RI
01
—
838-7
BCBSRI
RI
Enumeration date
04/05/2006
Last updated
10/04/2025
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