Individual
EDWARD BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-7139
(401) 444-7105
Mailing address
81 HIGHLAND AVE, SALEM, MA 01970-2714
(978) 741-1200
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
LP04750
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2018
Last updated
10/15/2024
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