Healthcare Provider Details

I. General information

NPI: 1144332586
Provider Name (Legal Business Name): NIKHIL SRIPATHI KARANTH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CUMBERLAND HILL RD SUITE 204
WOONSOCKET RI
02895-4854
US

IV. Provider business mailing address

4 EDELWEISS AVE
LINCOLN RI
02865-3607
US

V. Phone/Fax

Practice location:
  • Phone: 401-765-1750
  • Fax:
Mailing address:
  • Phone: 401-333-1938
  • Fax: 401-333-0412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD11310
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number230117
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301089173
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number230672
License Number StateMA
# 5
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD11310
License Number StateRI
# 6
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number230117
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number4301089173
License Number StateMI
# 8
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number230672
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: