Provider Demographics
NPI:1730414640
Name:SLADE, WILLIAM JOSEPH IV (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:SLADE
Suffix:IV
Gender:M
Credentials:DO
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Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:59 S COUNTY COMMONS WAY FL H32
Practice Address - Street 2:
Practice Address - City:SOUTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02879-8270
Practice Address - Country:US
Practice Address - Phone:401-783-0084
Practice Address - Fax:401-782-0005
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2024-04-02
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Provider Licenses
StateLicense IDTaxonomies
RIDO00705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIWS89832Medicaid