Healthcare Provider Details

I. General information

NPI: 1427216324
Provider Name (Legal Business Name): MARK APPLEMAN, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 FRIENDSHIP ST
NEWPORT RI
02840-2209
US

IV. Provider business mailing address

227 HILLTOP DR
PORTSMOUTH RI
02871-1207
US

V. Phone/Fax

Practice location:
  • Phone: 401-846-6400
  • Fax:
Mailing address:
  • Phone: 401-683-3591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number5502
License Number StateRI

VIII. Authorized Official

Name: MARK EDWARD APPLEMAN
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 401-683-3591