Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | MD12990 | RI |
NPI | 1013987353 |
---|---|
Provider Name | Dr. Christopher S. Nasin |
First Address | Kingston, RI 02881 |
Second Address | Kingston, RI 02881-1116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 14/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) |