Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | D78143 | MD |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD15160 | RI |
NPI | 1053623538 |
---|---|
Provider Name | Dr. Ricardo Rafael Correa Marquez |
First Address | Warren, RI 02885 |
Second Address | East Providence, RI 02914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2010 |
Last Update Date | 16/03/2016 |