Individual
JENNIFER L MAUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
909 N MAIN ST, SUITE 300, PROVIDENCE, RI 02904-5752
(401) 273-4064
(401) 273-1268
Mailing address
PO BOX 1358, PROVIDENCE, RI 02901-1358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD10059
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
JM32833
—
RI
Enumeration date
05/20/2006
Last updated
11/14/2007
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