Provider Demographics
NPI:1477661734
Name:TODOROV, LYUDMIL LYUDMILOV (MD)
Entity Type:Individual
Prefix:
First Name:LYUDMIL
Middle Name:LYUDMILOV
Last Name:TODOROV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MAIN ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4119
Mailing Address - Country:US
Mailing Address - Phone:401-726-7300
Mailing Address - Fax:401-726-7330
Practice Address - Street 1:111 BREWSTER ST
Practice Address - Street 2:DEPARTMENT OF ANESTHESIA
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4400
Practice Address - Country:US
Practice Address - Phone:401-726-7300
Practice Address - Fax:401-726-7330
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI11775207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI412829OtherBLUECHIP OF RI
RI7057727Medicaid
RI412829OtherBLUECHIP OF RI