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General NPI Number Information
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NPI Number | 1609863828
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Entity Type | Organization
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Legal Business Name | COASTAL MEDICAL INC
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 10 DAVOL SQ SUITE 400
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City | PROVIDENCE
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State | RI
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Zip | 02903-4754
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Country | US
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Telephone | 401-421-4000
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Fax | 401-453-3258
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Provider Business Mailing Address
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Address Line | 10 DAVOL SQ SUITE 400
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City | PROVIDENCE
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State | RI
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Zip | 02903-4754
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Country | US
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Telephone | 401-421-4000
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Fax | 401-453-3258
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Authorized Official
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Title or Position | COO
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Name | MERYL MOSS
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Credential |
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Telephone | 401-421-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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Taxonomy #9
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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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Taxonomy #10
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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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