Individual
MARY M HILLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2520
(401) 453-8220
Mailing address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2520
(401) 453-8220
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
151888
MA
2085R0202X
Diagnostic Radiology Physician
8660
RI
2085R0202X
Diagnostic Radiology Physician
Primary
MD08660
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001988
NHPRI
—
01
—
003109817
CT MED ASSISTANCE
—
01
—
004950
BLUE CHIP
—
01
—
007006235
HOSPITAL PIN
—
01
—
008660
TUFTS
—
01
—
1600203
UNITED HEALTH PLANS
—
01
—
240081
RIH PILGRIM
—
01
—
300084316
RR MEDICARE
—
01
—
3200388
HEALTHY START
—
05
—
3200388
—
MA
01
—
7003975
RI MEDICAL ASSISTANCE
—
01
—
720071101
CIGNA
—
01
—
8660
FEP BLUE CROSS
—
Enumeration date
10/13/2005
Last updated
03/25/2019
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