Provider Demographics
NPI:1124059936
Name:SPIZZIRRI, MICHAEL EDWARD (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDWARD
Last Name:SPIZZIRRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CUMBERLAND HILL RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895
Mailing Address - Country:US
Mailing Address - Phone:401-762-0700
Mailing Address - Fax:401-766-1095
Practice Address - Street 1:20 CUMBERLAND HILL RD
Practice Address - Street 2:SUITE 210
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895
Practice Address - Country:US
Practice Address - Phone:401-762-0700
Practice Address - Fax:401-766-1095
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIL4983207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0700127OtherUNITED HEALTH CARE
715529OtherTUFTS
RI9001498Medicaid
002165OtherHMO OF RI
14986OtherRIBC
AA2474OtherPILGRIM HEALTH
169001498Medicare ID - Type Unspecified
RI9001498Medicaid