Individual
MARTIN M. MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
164 SUMMIT AVE, FAIN BLDING, PROVIDENCE, RI 02906-2853
(401) 793-4636
(401) 793-4639
Mailing address
164 SUMMIT AVE, FAIN BLDING, PROVIDENCE, RI 02906-2853
(401) 793-4636
(401) 793-4639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6413
RI
207Q00000X
Family Medicine Physician
Primary
MD06413
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MM71802
—
RI
Enumeration date
04/14/2006
Last updated
03/20/2026
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