Provider Demographics
NPI:1134192206
Name:DRAGOMIRE, DANIEL LEE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LEE
Last Name:DRAGOMIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:81 RUMSTICK RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4821
Mailing Address - Country:US
Mailing Address - Phone:401-245-4205
Mailing Address - Fax:
Practice Address - Street 1:318 WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-3525
Practice Address - Country:US
Practice Address - Phone:401-438-5950
Practice Address - Fax:401-435-6700
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10334207RN0300X
MA229167207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI10334OtherRI BLUE CROSS
1134192206OtherTUFTS
RI050352774OtherUNITEDHEALTH
RI4155OtherNEIGHBORHOOD OF RI
MAJ40750OtherBLUE CROSS MA
0613770OtherCIGNA
MA110075536AMedicaid
RI407358OtherRI BLUE CHIP
00000038908OtherBOSTON MEDICAL
1405317OtherAETNA
RI73058525Medicaid
MAAA67162OtherHARVARD PILGRIM
00000038908OtherBOSTON MEDICAL
MAJ40750OtherBLUE CROSS MA
MA110075536AMedicaid