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General NPI Number Information
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NPI Number | 1548352990
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Entity Type | Individual
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Provider Name | EDMUND T DOSREMEDIOS DPM
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 235 PLAIN STREET SUITE 201
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City | PROVIDENCE
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State | RI
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Zip | 02905-3240
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Country | US
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Telephone | 401-861-8830
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Fax | 401-351-2378
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Provider Business Mailing Address
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Address Line | DEPT 3010, PO BOX 986524
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City | BOSTON
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State | MA
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Zip | 02298-6524
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Country | US
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Telephone | 833-924-5546
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | DPM00296
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License Number State | RI
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