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Individual

ELKIN O ESTRADA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1076 N MAIN ST, PROVIDENCE, RI 02904-5760
(401) 861-7711
(401) 421-5710
Mailing address
1076 N MAIN ST, PROVIDENCE, RI 02904-5760
(401) 861-7711
(401) 421-5710

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD10888
RI
207RN0300X
Nephrology Physician
Primary
MD10888
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7009622
RI
Enumeration date
07/07/2005
Last updated
07/12/2010
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