Provider Demographics
NPI:1518018811
Name:CANCHIS, P WILFREDO (MD)
Entity Type:Individual
Prefix:DR
First Name:P
Middle Name:WILFREDO
Last Name:CANCHIS
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 1:2 FERNCREST CT
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4732
Mailing Address - Country:US
Mailing Address - Phone:401-727-0006
Mailing Address - Fax:
Practice Address - Street 1:1526 ATWOOD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3289
Practice Address - Country:US
Practice Address - Phone:401-273-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine