Organization
DANIEL T SHREVE MD INC
Active
Parent organization
DANIEL T SHREVE MD INC
Other names
DANIEL T SHREVE MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
DANIEL T SHREVE MD INC
Authorized official
DR. DANIEL T SHREVE M.D. (PHYSICIAN)
(401) 434-9100
Entity
Organization
Contact information
Practice address
47 HAZARD AVE, EAST PROVIDENCE, RI 02914-3309
(401) 434-9100
(401) 434-4732
Mailing address
47 HAZARD AVE, EAST PROVIDENCE, RI 02914-3309
(401) 434-9100
(401) 434-4732
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD03558
RI
302F00000X
Exclusive Provider Organization
MD03558
RI
305S00000X
Point of Service
MD03558
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134239767
DANIEL T SHREVE MD INC
RI
05
—
9001447
—
RI
Enumeration date
08/25/2016
Last updated
08/25/2016
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