NPI 1104312909 · live from the CMS NPI Registry
John Charles Mach, DO
Radiology, Diagnostic Radiology in Providence, RI. National Provider Identifier 1104312909, active.
NPI record
| NPI | 1104312909 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 593 Eddy St, Providence, RI 02903 |
| Practice phone | 401-432-2500 |
| Mailing address | 125 Metro Center Blvd Ste 2000, Warwick, RI 02886 |
| Enumerated | July 3, 2018 |
| Last updated | September 18, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology | 2085R0202X | 5151014051 (MI) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | DO01312 (RI) |
| Radiology, Diagnostic Radiology | 2085R0202X | 032.0134262 (VT) |
| Internal Medicine | 207R00000X | 275719 (MA) |
| Radiology, Diagnostic Radiology | 2085R0202X | 295543 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.