Individual
BERTRAM ALLEN FLAXMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
189 GOVERNOR ST, PROVIDENCE, RI 02906
(401) 331-1008
(401) 861-6761
Mailing address
189 GOVERNOR ST, PROVIDENCE, RI 02906
(401) 331-1008
(401) 861-6761
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
28301
MA
207N00000X
Dermatology Physician
Primary
RI4029
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300101
UNITED HEALTH
RI
01
—
243
BCBS
RI
05
—
9000243
—
RI
Enumeration date
11/27/2006
Last updated
03/24/2011
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