Individual
MARINA KUPERMAN-BEADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., F.A.A.D.
Contact information
Practice address
1030 PRESIDENT AVE STE 306, FALL RIVER, MA 02720-5923
(401) 751-7546
(401) 751-6888
Mailing address
1 RANDALL SQUARE, SUITE 306, PROVIDENCE, RI 02904-2709
(401) 751-7546
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD10753
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9023992
—
RI
01
—
P00241153
RAILROAD MEDICARE
RI
Enumeration date
07/18/2006
Last updated
04/01/2019
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