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Contact Information

ANDREW GRISCOM, MD
111 BREWSTER ST
DEPARTMENT OF EMERGENCY MEDICINE
PAWTUCKET, RI02860-4400
 Phone: 401-729-2191
 Fax: 401-729-2517
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for ANDREW GRISCOM · (Male)

NPI Number 1538142328
Status Active
Credentials MD
Entity Individual
Enumeration date 11/25/2005
Last updated 05/15/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 34668
  • RI License # MD09664
  • RI Medicaid 7006158
  • RI Other 007061007 MEDICARE PTAN
Hospital affiliation(s)
  • ST JOSEPH HEALTH SERVICES OF RI - (Acute Care)
    200 HIGH SERVICE AVENUE
    NORTH PROVIDENCE, RI 02904
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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