Ettensohn, David B
Ettensohn, David B is an sole proprietor health care provider with primary practice located at 73 Beechwood Avenue , Pawtucket RI 02860. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Ettensohn, David B can be contacted via phone (401) 724-4040.Contact Information
Primary practice address
73 Beechwood Avenue
Pawtucket RI 02860
Phone: (401) 724-4040
Fax: (401) 722-9575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 6164 | Rhode Island |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 6164 | Rhode Island |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 06164 | Rhode Island |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 06164 | Rhode Island |
Profile Details
| NPI number | 1134186067 |
|---|---|
| LBN Legal business name | Ettensohn, David B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Sep 20th, 2013 - about 13 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 | 1134186067 | NPPES |
| Rhode Island | Other | 6164 | RI MEDICAL LICENSE # |
| Rhode Island | MEDICAID | 7000422 | RI MEDICAL LICENSE # |
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