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Individual

RANDALL LEE UPDEGROVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1405 S COUNTY TRL, SUITE 510, EAST GREENWICH, RI 02818-5081
(401) 884-9605
(401) 884-9882
Mailing address
2 DUDLEY ST, SUITE, PROVIDENCE, RI 02905-3236
(401) 884-9605

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
8772
RI
2083X0100X
Occupational Medicine Physician
Primary
08772
RI

Other

Enumeration date
06/01/2006
Last updated
02/07/2012
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