Healthcare Provider Details

I. General information

NPI: 1114927431
Provider Name (Legal Business Name): DR. DAVID B. STOLL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HAMLET AVE
WOONSOCKET RI
02895-4432
US

IV. Provider business mailing address

55 HAMLET AVE
WOONSOCKET RI
02895-4432
US

V. Phone/Fax

Practice location:
  • Phone: 401-766-9500
  • Fax: 401-766-7464
Mailing address:
  • Phone: 401-766-9500
  • Fax: 401-766-7464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number6416
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: