# VMD PRIMARY PROVIDERS OF RHODE ISLAND PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VMD PRIMARY PROVIDERS OF RHODE ISLAND PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649056508
- **Legal business name:** VMD PRIMARY PROVIDERS OF RHODE ISLAND PC
- **Authorized official:** FONDA SHANKS (DIRECTOR REV CYCLE)
- **Authorized official phone:** (844) 969-0686

## Contact information

- **Practice address:** 400 PUTNAM PIKE, SMITHFIELD, RI 02917-2408
- **Practice address phone:** (401) 757-6160
- **Practice address fax:** (401) 349-0840
- **Mailing address:** PO BOX 30034, BELFAST, ME 04915-2052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/06/2023
- **Last updated:** 01/14/2025