Individual
CHARLENE A TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 DUDLEY ST, SUITE 555, PROVIDENCE, RI 02905-3236
(401) 444-6168
Mailing address
1 HOPPIN ST, SUITE 318, PROVIDENCE, RI 02903-4141
(401) 793-8382
(401) 793-8312
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD08409
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7005405
—
RI
Enumeration date
06/13/2006
Last updated
07/08/2007
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