Individual
ROBERT WOLFGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1150 RESERVOIR AVE, SUITE 201, CRANSTON, RI 02920-6068
(401) 943-1300
(401) 946-8480
Mailing address
1150 RESERVOIR AVE, SUITE 201, CRANSTON, RI 02920-6068
(401) 943-1300
(401) 946-8480
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
RI501
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IM02288
—
RI
Enumeration date
09/08/2005
Last updated
03/29/2010
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