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General NPI Number Information
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NPI Number | 1912000894
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Entity Type | Organization
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Legal Business Name | DUANE T GOLOMB MD INC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 766 WASHINGTON ST
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City | CORENTRY
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State | RI
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Zip | 02816
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Country | US
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Telephone | 401-822-2772
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Fax | 401-821-5260
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Provider Business Mailing Address
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Address Line | 766 WASHINGTON ST
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City | CORENTRY
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State | RI
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Zip | 02816
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Country | US
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Telephone | 401-822-2772
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Fax | 401-821-5260
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DUANE THOMAS GOLOMB
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Credential | MD
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Telephone | 401-822-2772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6442
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License Number State | RI
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