Michelow, Ian Charles

Michelow, Ian Charles is an individual health care provider with primary practice located at 593 Eddy St , Providence RI 02903-4923. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases. Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases is his primary health care specialty. Michelow, Ian Charles can be contacted via phone (401) 444-8360.

Contact Information

Primary practice address
593 Eddy St Providence RI 02903-4923
Phone: (401) 444-8360
Fax: (401) 444-5650
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 216301 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases 2080P0208X MD13482 Rhode Island

Profile Details

NPI number 1386634756
LBN Legal business name Michelow, Ian Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Sep 15th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386634756 NPPES
Massachusetts Other J26918 BCBS MA
Massachusetts Other MD13482 BCBS MA
Massachusetts Other 468557 BCBS MA
Massachusetts MEDICAID 2026091 BCBS MA

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