Provider Demographics
NPI:1013172527
Name:BARRETT, MICHAEL SCANLAN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SCANLAN
Last Name:BARRETT
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 LISTER DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-2504
Mailing Address - Country:US
Mailing Address - Phone:401-245-8877
Mailing Address - Fax:401-247-1694
Practice Address - Street 1:24 LISTER DR
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-2504
Practice Address - Country:US
Practice Address - Phone:401-245-8877
Practice Address - Fax:401-247-1694
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD038422086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI029002166Medicare PIN