Provider Demographics
NPI:1831778851
Name:AGUIRRE, JESUS ISMAEL JR (MD)
Entity type:Individual
Prefix:DR
First Name:JESUS
Middle Name:ISMAEL
Last Name:AGUIRRE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:DEPT 3010, PO BOX 986524
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02298-6524
Mailing Address - Country:US
Mailing Address - Phone:401-443-4992
Mailing Address - Fax:401-784-4913
Practice Address - Street 1:375 WAMPANOAG TRL STE 201
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-2234
Practice Address - Country:US
Practice Address - Phone:401-649-4020
Practice Address - Fax:401-649-4021
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD20710207R00000X
RILP05598390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine