Jack R Bevivino, MD
Plastic Surgery in Providence, RI. Individual provider (NPI-1).
NPI number1780705707
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1780705707
- Entity type
- Individual (NPI-1)
- Name
- Jack R Bevivino
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 3, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208200000X | Plastic Surgery | RIMD05259 | RI | Yes |
Practice location
120 Dudley StreetSuite #201
Providence, RI 02905-2431
Phone 401-521-9290 · Fax 401-521-9297
Mailing address
120 Dudley StreetSuite #201
Providence, RI 02905-2431
Phone 401-521-9290 · Fax 401-521-9297
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Other Plastic Surgery Physician providers in Providence, RI
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- Mimi Rosealie BorrelliNPI 1649894924
- Lawrence P Bowen, M. D.NPI 1881874311
- Karl Heinz Breuing, MDNPI 1720044472
- Jonathan P Brower, M.D.NPI 1255778361
- Center For Plastic And Hand Surgery PCNPI 1013219492
- David Chi, MD, PHDNPI 1780178830
- Lee Everett Edstrom, M.D.NPI 1669566303
All 28 Plastic Surgery Physician providers in Providence · All 11,044 providers in Providence
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