Individual
TEDDI LYNN TUBRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5057
(401) 606-1233
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5057
(401) 606-1233
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
LP05000
RI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
TEP7574
NE
Other
Enumeration date
07/21/2015
Last updated
07/02/2020
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