Edstrom, Lee Everett
Edstrom, Lee Everett is an sole proprietor health care provider with primary practice located at 2 Dudley Suite 460, Providence RI 02905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Edstrom, Lee Everett can be contacted via phone (401) 331-2303.Contact Information
Primary practice address
2 Dudley Suite 460
Providence RI 02905
Phone: (401) 331-2303
Fax: (401) 331-4430
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 5949 | Rhode Island |
Profile Details
| NPI number | 1669566303 |
|---|---|
| LBN Legal business name | Edstrom, Lee Everett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Mar 7th, 2023 - about 2 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 | 1669566303 | NPPES |
| Rhode Island | Other | 1300121 | UNITED HEALTH |
| Rhode Island | Other | 300043 | UNITED HEALTH |
| Rhode Island | Other | 050395339 | UNITED HEALTH |
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