Healthcare Provider Details

I. General information

NPI: 1720202716
Provider Name (Legal Business Name): ROGER J FERLAND, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 EDDY ST 22
PROVIDENCE RI
02903-4941
US

IV. Provider business mailing address

695 EDDY ST
PROVIDENCE RI
02903-4941
US

V. Phone/Fax

Practice location:
  • Phone: 401-331-0669
  • Fax:
Mailing address:
  • Phone: 401-331-0669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License NumberRI6030
License Number StateRI

VIII. Authorized Official

Name: SANDY SMITH
Title or Position: PRACTICE MANAGER
Credential:
Phone: 401-331-0669