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General NPI Number Information
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NPI Number | 1386948719
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Entity Type | Organization
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Legal Business Name | GERET A DU BOIS MD, INC
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 330 COTTAGE ST
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City | PAWTUCKET
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State | RI
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Zip | 02860
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Country | US
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Telephone | 401-723-8300
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Fax | 401-723-8008
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Provider Business Mailing Address
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Address Line | P.O. BOX L
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City | PAWTUCKET
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State | RI
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Zip | 02861-0730
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Country | US
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Telephone | 401-723-8300
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Fax | 401-723-8008
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Authorized Official
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Title or Position | PRESIDENT
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Name | GERET ALAN DU BOIS
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Credential | MD
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Telephone | 401-723-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4693
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License Number State | RI
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