Etienne, Alex

Etienne, Alex is an individual health care provider with primary practice located at 825 Chalkstone Ave , Providence RI 02908-4728. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Etienne, Alex can be contacted via phone (401) 456-2363.

Contact Information

Primary practice address
825 Chalkstone Ave Providence RI 02908-4728
Phone: (401) 456-2363
Fax: (401) 456-6744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD11719 Rhode Island
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X MD11719 Rhode Island
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X MD11719 Rhode Island

Profile Details

NPI number 1447221866
LBN Legal business name Etienne, Alex
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Mar 13th, 2012 - about 12 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 1447221866 NPPES
Rhode Island MEDICAID 7058051
Rhode Island Other 412896
Rhode Island Other 29918

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