Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DCP00347 | RI |
NPI | 1043308976 |
---|---|
Provider Name | Dr. Robert Colin Campbell |
First Address | Westerly, RI 02891-2601 |
Second Address | Westerly, RI 02891-2601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 10/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Y22355 | (02) | RI |