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1457399388

NPI Code Detail

MEDICARE: DR. NITIN S DAMLE MD

MEDICARE: DR. NITIN S DAMLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD07066	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0406618	OTHER	RI	UNITEDHEALTHCARE
3	MD07066	OTHER	RI	RI STATE LICENSE
4	004027	OTHER	RI	HMORI OF RI
5	RI7066	OTHER	RI	BLUE SHIELD OF RI

General Provider Information

NPI Number	:	1457399388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NITIN S DAMLE MD

Provider Business Mailing Address
First Line	:	481 KINGSTOWN RD
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-3626
Country	:	US
Telephone Number	:	401-789-0283
Fax Number	:	401-789-0314

Provider Business Practice Location Address
First Line	:	481 KINGSTOWN RD
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-3626
Country	:	US
Telephone Number	:	401-789-0283
Fax Number	:	401-789-0314

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	06/25/2010

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Directions to “ DR. NITIN S DAMLE MD” Practice Location

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