Muetterties, Mark Conrad

Muetterties, Mark Conrad is an individual health care provider with primary practice located at 11 Friendship St , Newport RI 02840-2271. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Muetterties, Mark Conrad can be contacted via phone (401) 845-1593.

Contact Information

Primary practice address
11 Friendship St Newport RI 02840-2271
Phone: (401) 845-1593
Fax: (401) 847-0650
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD10743 Rhode Island

Profile Details

NPI number 1184681082
LBN Legal business name Muetterties, Mark Conrad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jun 4th, 2015 - about 11 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 1184681082 NPPES
Rhode Island Other U400167716 MEDICARE NGS
Rhode Island MEDICAID 7057902 MEDICARE NGS

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