Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC 264 | RI |
NPI | 1699806448 |
---|---|
Provider Name | Dr. John Thomas Sotis |
First Address | Warwick, RI 02886-1547 |
Second Address | Warwick, RI 02886-1547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9074-8 | BLUE CROSS PROVIDER NO. (01) | RI |
CPOOOO4698 | BLUE CHIP PROVIDER (01) | RI |