Individual
DR. MARK E. MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-3985
(401) 444-3986
Mailing address
PO BOX 1358, PROVIDENCE, RI 02901-1358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD07209
RI
Other
Enumeration date
09/29/2005
Last updated
07/08/2008
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