Provider Demographics
NPI:1720202716
Name:ROGER J FERLAND, M.D., P.C.
Entity Type:Organization
Organization Name:ROGER J FERLAND, M.D., P.C.
Other - Org Name:GYN SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-331-0669
Mailing Address - Street 1:695 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4941
Mailing Address - Country:US
Mailing Address - Phone:401-331-0669
Mailing Address - Fax:
Practice Address - Street 1:695 EDDY ST
Practice Address - Street 2:22
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4941
Practice Address - Country:US
Practice Address - Phone:401-331-0669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI6030207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI02345-6OtherBLUE CROSS RHODE ISLAND
662292OtherTUFTS HEALTH PLAN
RI9004039Medicaid
RI0899OtherNEIGHBORHOOD HEALTH
13883OtherHARVARD PILGRIM
RI709004039Medicare PIN