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Organization

BROWN MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA GORDON (RCM DIRECTOR)
(401) 443-5107
Entity
Organization

Contact information

Practice address
375 WAMPANOAG TRL, RIVERSIDE, RI 02915-2232
(401) 444-7793
Mailing address
DEPT 3010, PO BOX 986524, BOSTON, MA 02298-6524
(401) 443-4992
(401) 537-7241

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
207R00000X
Internal Medicine Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
207RI0200X
Infectious Disease Physician
207RR0500X
Rheumatology Physician
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
363AM0700X
Medical Physician Assistant
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
05/20/2022
Last updated
02/14/2024
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