Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 7780 | NH |
NPI | 1063425700 |
---|---|
Provider Name | Prof. Stephen N. Rous |
First Address | Newport, RI 02840-6946 |
Second Address | Providence, RI 02908-4734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 08/07/2007 |