Etienne, Alex
Etienne, Alex is an individual health care provider with primary practice located at 825 Chalkstone Ave , Providence RI 02908-4728. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Etienne, Alex can be contacted via phone (401) 456-2363.Contact Information
Primary practice address
825 Chalkstone Ave
Providence RI 02908-4728
Phone: (401) 456-2363
Fax: (401) 456-6744
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD11719 | Rhode Island |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | MD11719 | Rhode Island |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD11719 | Rhode Island |
Profile Details
| NPI number | 1447221866 |
|---|---|
| LBN Legal business name | Etienne, Alex |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2006 |
| Last updated | Mar 13th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447221866 | NPPES |
| Rhode Island | MEDICAID | 7058051 | |
| Rhode Island | Other | 412896 | |
| Rhode Island | Other | 29918 |
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