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Individual

JOAN C GODDARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
180 CORLISS ST STE B, PROVIDENCE, RI 02904-2602
(401) 793-8400
(401) 793-8402
Mailing address
180 CORLISS ST STE B, PROVIDENCE, RI 02904-2602
(401) 793-8400
(401) 793-8402

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD06754
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0181099
MA
05
7002212
RI
Enumeration date
06/27/2005
Last updated
10/19/2020
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