Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 31719 | MA |
N | 208600000X | Surgeon | 31719 | MA |
Y | 208200000X | Surgeon | MD04946 | RI |
Y | 208600000X | Surgeon | MD04946 | RI |
N | 2086S0129X | Vascular Surgeon | MD4946 | RI |
NPI | 1104872688 |
---|---|
Provider Name | Frank J Schaberg |
First Address | Pawtucket, RI 02860-4400 |
Second Address | Pawtucket, RI 02860-4400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 26/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9006523 | (05) | RI |
D87556 | (02) |