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General NPI Number Information
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NPI Number | 1144486846
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Entity Type | Organization
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Legal Business Name | NORTHERN RHODE ISLAND MEDICAL GROUP
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 63 EDDIE DOWLING HWY
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City | N SMITHFIELD
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State | RI
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Zip | 02896-7322
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Country | US
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Telephone | 401-762-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 42 HEMINGWAY DR
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City | RIVERSIDE
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State | RI
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Zip | 02915-2224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FATHALLA MASHALI
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Credential |
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Telephone | 401-490-2130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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