Healthcare Provider Details

I. General information

NPI: 1063876944
Provider Name (Legal Business Name): WILLIAM B BELIVEAU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 ATWOOD AVE STE 220
JOHNSTON RI
02919-3288
US

IV. Provider business mailing address

1524 ATWOOD AVE STE 220
JOHNSTON RI
02919-3288
US

V. Phone/Fax

Practice location:
  • Phone: 401-272-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD16547
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD16547
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: