Doctor Name: | ALBERT EDWARD DAHLBERG |
NPI Number: | 1306188909 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 4434 |
Business Practice Address: | 185 Meeting St Room L-254, Sfh, Brown University Providence, RI - 029120001 |
Business Phone Number: | 4018632223 |
Business Fax Number: | 4018631201 |
Mailing Address: | 185 Meeting St, Room L-254, Sfh, Brown University PROVIDENCE |
State: | RI |
Postal Code: | 029120001 |
Phone Number: | 4018632223 |
Fax Number: | 4018631201 |
NPI Enumeration Date: | 03/21/2013 |
NPI Last Update Date: | 03/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4434 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |