Individual
DR. DICKEN SHIU-CHUNG KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 COLLYER ST STE 201, PROVIDENCE, RI 02904-1869
(401) 272-7799
(401) 453-9078
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
042.0012769
VT
204F00000X
Transplant Surgery Physician
MD16976
RI
208800000X
Urology Physician
Primary
79821
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079821
TUFTS HEALTH PLAN
MA
05
—
3164845
—
MA
01
—
J17470
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
03/10/2026
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