Provider Demographics
NPI:1053623538
Name:CORREA MARQUEZ, RICARDO RAFAEL (MD)
Entity type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:RAFAEL
Last Name:CORREA MARQUEZ
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 1:1 EVIE DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885
Mailing Address - Country:US
Mailing Address - Phone:786-246-5719
Mailing Address - Fax:
Practice Address - Street 1:900 WARREN AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914
Practice Address - Country:US
Practice Address - Phone:786-246-5719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78143207RE0101X
RIMD15160207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism