Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | CO00007 | RI |
N | 222Z00000X | Podiatrist | CO00007 | RI |
N | 224P00000X | Prosthetist | CO00007 | RI |
NPI | 1174657795 |
---|---|
Provider Name | Mr. Warren Alfred Carlow JR. |
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 |
---|---|---|
1528157 | (05) | MA |
9009703 | (05) | RI |
9703 | BLUE CROSS OF RI (01) | RI |