Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | CO00008 | RI |
N | 222Z00000X | Podiatrist | CO00008 | RI |
N | 224P00000X | Prosthetist | CP00012 | RI |
N | 225000000X | Orthotic Fitter | CO00008 | RI |
NPI | 1467586008 |
---|---|
Provider Name | Mr. Matthew Warren Carlow |
First Address | Cranston, RI 02920-4406 |
Second Address | Cranston, RI 02920-4406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200260 | BLUECHIP (01) | RI |
9009703 | (05) | RI |
9703 | BCBS OF RI (01) | RI |