Individual
CARMEN TINA KHORRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(980) 322-5885
Mailing address
255 PROMENADE ST APT 609, PROVIDENCE, RI 02908-5776
(980) 322-5885
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
19042
FL
207L00000X
Anesthesiology Physician
Primary
MD15994
RI
Other
Enumeration date
06/26/2013
Last updated
09/21/2020
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