Individual
MICHAEL 'R' SHOULBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
37 POTTER AVE, WEST WARWICK, RI 02893-4610
(860) 694-3505
Mailing address
37 POTTER AVE, WEST WARWICK, RI 02893-4610
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/01/2008
Last updated
08/01/2008
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