Individual
DR. DANIEL H. LEDERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6309
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6309
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD04938
RI
207RP1001X
Pulmonary Disease Physician
MD04938
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000021016
BLUE SHIELD OF RHODE ISLAND
RI
01
—
001290
BLUE CHIP
RI
01
—
0402683
UNITED HEALTHCARE
RI
01
—
110206706
RAILROAD MEDICARE
RI
01
—
119021016
MEDICARE OF RHODE ISLAND
RI
01
—
406113
TUFTS HEALTH PLAN
RI
01
—
7003866
MEDICAID OF RHODE ISLAND
RI
Enumeration date
07/28/2006
Last updated
05/05/2008
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