Provider Demographics
NPI:1992731913
Name:SACHS, GEORGE M (MD, PHD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:SACHS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DUDLEY ST
Mailing Address - Street 2:SUITE 555
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4141
Mailing Address - Country:US
Mailing Address - Phone:401-444-8761
Mailing Address - Fax:401-444-5929
Practice Address - Street 1:2 DUDLEY ST
Practice Address - Street 2:SUITE 555
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3236
Practice Address - Country:US
Practice Address - Phone:401-444-8761
Practice Address - Fax:401-444-5929
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD082242084N0400X
MA728012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7002871Medicaid
RI007002871Medicare ID - Type Unspecified
RI7002871Medicaid