Individual
MAY MIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
950 WARREN AVE STE 301, EAST PROVIDENCE, RI 02914-1432
(401) 606-4260
Mailing address
950 WARREN AVE STE 301, EAST PROVIDENCE, RI 02914-1432
(401) 606-4260
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
LP04663
RI
207RG0100X
Gastroenterology Physician
Primary
MD18601
RI
Other
Enumeration date
03/31/2015
Last updated
06/22/2022
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