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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 last year

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 1669566303 NPPES
Rhode Island Other 1300121 UNITED HEALTH
Rhode Island Other 300043 UNITED HEALTH
Rhode Island Other 050395339 UNITED HEALTH

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