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Contact Information

MICHAEL WALLACH, MD
20 CATAMORE BLVD
EAST PROVIDENCE, RI02914
 Phone: 401-432-2520
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for MICHAEL WALLACH · (Male)

NPI # 1841261591
Status Active
Credentials MD
Entity Individual
Enumeration date 01/31/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • RI License # 7329
  • Other W&I PILGRIM 240161
  • Other 004389 BLUE CHIP
  • Other 007329 BLUE SHIELD
  • Other 7329 FEP BLUE CROSS
  • Other 3207765 HEALTHY START
  • Other 3207765 MASS MEDICAID
  • Other 000000001988 NHPRI
  • Other 7000630 RI MEDICAL ASSISTANCE
  • Other 240161 RIH PILGRIM
  • Other 007329 TUFTS
  • Other 1600203 UNITED HEALTH PLANS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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