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DR. DENIS E MOONAN M.D.

Physicians Internal Medicine Addiction Medicine

Provider NPI: 1386626174

Provider Information:
DR. DENIS E MOONAN M.D.
Gender: M
Sole Proprietor

Practice Location:
1515 SMITH ST SUITE N NORTH PROVIDENCE, RI 02911-2947 US
Tel: 401-353-0555  Fax: 401-353-7079

Business Mailing Address:
1515 SMITH ST SUITE N NORTH PROVIDENCE, RI 02911-2947 US
Tel: 401-353-0555  Fax: 401-353-7079

NPI Information:
NPI: 1386626174
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207RA0401XPhysicians
Internal Medicine
Addiction Medicine
RIMD05654
Y207RG0300XPhysicians
Internal Medicine
RIMD05654
N207ZP0101XPhysicians
Pathology
RIMD05654

Other Provider Identifiers:

IssuerNumberStateType
9002408RI05
BLUE CROSS BLUE SHIELD24088RI01



American Medical Association 2012 taxonomy code information

Code: 207RG0300X

Type:

Classification:



Definition:



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