NPI 1306809603 · live from the CMS NPI Registry
Jonathan G Sabourin, DPM
Podiatrist in Middletown, RI. National Provider Identifier 1306809603, active.
NPI record
| NPI | 1306809603 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 850 Aquidneck Ave Ste 15, Middletown, RI 02842 |
| Practice phone | 401-849-2157 |
| Enumerated | April 8, 2006 |
| Last updated | June 16, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | DPM00316 (RI) |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | 2210 (MA) |
| Podiatrist primary | 213E00000X | DPM00316 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.