Provider Demographics
NPI:1902052558
Name:T.W. TSCHIRLEY MD INC
Entity type:Organization
Organization Name:T.W. TSCHIRLEY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:TSCHIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:401-273-2730
Mailing Address - Street 1:1524 ATWOOD AVE STE 434
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-273-2730
Mailing Address - Fax:401-831-9025
Practice Address - Street 1:1524 ATWOOD AVE STE 434
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-273-2730
Practice Address - Fax:401-831-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI4951207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9020212Medicaid
RIE55187Medicare UPIN
RI9020212Medicaid