Individual
TRACEY MICHELLE GUTHRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6293
Mailing address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4800
(401) 455-6200
(401) 455-6293
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD09580
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02246371
—
NY
01
—
1093831646
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
—
01
—
1104801349
BUTLER HOSPITAL NPI
RI
01
—
15-11636
UNITED BEHAVIORAL HEALTH
RI
01
—
20853-4
BLUE CROSS BLUE SHIELD
RI
01
—
405684
BLUE CHIP
RI
05
—
7007147
—
RI
01
—
P00402004
MEDICARE RAILROAD
RI
Enumeration date
07/28/2006
Last updated
07/03/2008
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