Individual
MARK JAMES GODDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4741
(401) 444-4445
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4741
(401) 444-4445
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LP04582
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LP04582
—
RI
Enumeration date
05/24/2019
Last updated
05/24/2019
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