Provider Demographics
NPI:1851409247
Name:DECELLES, NORMAND LOUIS JR (MD)
Entity type:Individual
Prefix:DR
First Name:NORMAND
Middle Name:LOUIS
Last Name:DECELLES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2090 WALLUM LAKE RD
Mailing Address - Street 2:ELEANOR SLATER HOSPITAL / ZAMBARANO UNIT
Mailing Address - City:PASCOAG
Mailing Address - State:RI
Mailing Address - Zip Code:02859-1813
Mailing Address - Country:US
Mailing Address - Phone:401-567-5400
Mailing Address - Fax:401-567-4001
Practice Address - Street 1:2090 WALLUM LAKE RD
Practice Address - Street 2:ELEANOR SLATER HOSPITAL / ZAMBARANO UNIT
Practice Address - City:PASCOAG
Practice Address - State:RI
Practice Address - Zip Code:02859-1813
Practice Address - Country:US
Practice Address - Phone:401-567-5400
Practice Address - Fax:401-567-4001
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2012-02-21
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Provider Licenses
StateLicense IDTaxonomies
RIMD06902207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIE73547Medicare UPIN