Coburn, Michael C

Coburn, Michael C is an sole proprietor health care provider with primary practice located at 1950 Tower Hill Rd , North Kingstown RI 02852-6639. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Coburn, Michael C can be contacted via phone (401) 559-3954.

Contact Information

Primary practice address
1950 Tower Hill Rd North Kingstown RI 02852-6639
Phone: (401) 559-3954
Fax: (401) 294-4116
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X MD08308 Rhode Island

Profile Details

NPI number 1720040728
LBN Legal business name Coburn, Michael C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 5th, 2006
Last updated Mar 17th, 2018 - about 6 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 1720040728 NPPES
Rhode Island Other 005185 BCBSRI/CHIP
Rhode Island Other 838-7 BCBSRI/CHIP
Rhode Island MEDICAID 7004684 BCBSRI/CHIP

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