Individual
DR. ANDREW MINORU FUKUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4829
(401) 455-6346
(401) 455-6532
Mailing address
345 BLACKSTONE BLVD, BOX G-BH, PROVIDENCE, RI 02906-4800
(401) 455-6375
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD17238
RI
Other
Enumeration date
06/27/2018
Last updated
10/15/2024
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