Individual
CARLOS H NIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 TOLLGATE RD, SUITE 301A, WARWICK, RI 02886
(401) 739-4844
(401) 739-4415
Mailing address
300 TOLLGATE RD, SUITE 301A, WARWICK, RI 02886
(401) 739-4844
(401) 739-4415
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
04725
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2279-4
RI BLUE CROSS
RI
Enumeration date
06/19/2006
Last updated
11/25/2008
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