Flaxman, Bertram Allen

Flaxman, Bertram Allen is an individual health care provider with primary practice located at 189 Governor St , Providence RI 02906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Flaxman, Bertram Allen can be contacted via phone (401) 331-1008.

Contact Information

Primary practice address
189 Governor St Providence RI 02906
Phone: (401) 331-1008
Fax: (401) 861-6761
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X RI4029 Rhode Island
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 28301 Massachusetts

Profile Details

NPI number 1962578617
LBN Legal business name Flaxman, Bertram Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2006
Last updated Mar 24th, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962578617 NPPES
Rhode Island Other 243 BCBS
Rhode Island MEDICAID 9000243 BCBS
Rhode Island Other 0300101 BCBS

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