Individual
KIMBERLY A DODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 CHESTNUT ST STE 4, PROVIDENCE, RI 02903-4649
(833) 229-0957
Mailing address
111 BREWSTER STREET, PAWTUCKET, RI 02860-4400
(401) 729-3469
(401) 729-2541
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
232516
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD13173
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000137802
MEDICARE PTAN
RI
05
—
KD79114
—
RI
Enumeration date
06/11/2007
Last updated
04/10/2020
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