Provider Demographics
NPI:1376609180
Name:TSIARAS, WILLIAM G (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:G
Last Name:TSIARAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:78 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4417
Mailing Address - Country:US
Mailing Address - Phone:401-831-4592
Mailing Address - Fax:401-831-4643
Practice Address - Street 1:78 BAKER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-4417
Practice Address - Country:US
Practice Address - Phone:401-831-4592
Practice Address - Fax:401-831-4643
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI4952207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI002289OtherBCBS - BLUE CHIP
RI9000834Medicaid
RI9810OtherNEIGHBORHOOD HEALTH PLAN OF RI
RI15064RIHOtherHARVARD PILGRIM HEALTHCARE
RI180021373OtherRAILROAD MEDICARE
RI834OtherBCBS OF RI
RI834OtherBCBS OF RI
RIC-90046Medicare UPIN