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Organization

HAROLD J WANEBO MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HAROLD J WANEBO MD (OWNER)
(401) 529-2828
Entity
Organization

Contact information

Practice address
1165 N MAIN ST, 2ND FLOOR, PROVIDENCE, RI 02904-5740
(401) 529-2828
(401) 943-1958
Mailing address
1165 N MAIN ST, 2ND FLOOR, PROVIDENCE, RI 02904-5740
(401) 529-2828
(401) 943-1958

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
MD07200
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9006428
RI
Enumeration date
04/15/2014
Last updated
03/26/2015
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