Provider Demographics
NPI:1770510091
Name:MCNIECE, DONALD MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:MICHAEL
Last Name:MCNIECE
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 1:24 SALT POND RD
Mailing Address - Street 2:H1
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879
Mailing Address - Country:US
Mailing Address - Phone:401-789-2424
Mailing Address - Fax:401-782-1076
Practice Address - Street 1:24 SALT POND RD
Practice Address - Street 2:H1
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879
Practice Address - Country:US
Practice Address - Phone:401-789-2424
Practice Address - Fax:401-782-1076
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI5578207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9002182Medicaid
RI9002182Medicaid
119002182Medicare ID - Type Unspecified