Individual
LAUREN GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1351 S COUNTY TRL STE 301, EAST GREENWICH, RI 02818-5083
(401) 398-0860
(401) 398-0638
Mailing address
1351 S COUNTY TRL STE 301, EAST GREENWICH, RI 02818-5083
(401) 398-0860
(401) 398-0638
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD15136
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD15136
RI LICENSE
RI
Enumeration date
06/11/2012
Last updated
12/29/2020
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