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Individual

DR. FREDERICK AUGUSTUS GODLEY III

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
845 N MAIN ST, SUITE 1, PROVIDENCE, RI 02904-5700
(401) 331-9690
(401) 331-9609
Mailing address
845 N MAIN ST, SUITE 1, PROVIDENCE, RI 02904-5700
(401) 331-9690
(401) 331-9609

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD7590
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10-00234
UNITED HEALTH PLAN
RI
01
1594
NEIGHBORHOOD HEALTH PLAN
RI
01
19892
HARVARD PILGRIM HEALTH CA
MA
01
20996-0
BLUE CROSS BLUE SHIELD
RI
01
2255578
AETNA
RI
01
406139
BLUE CHIP OF RI
RI
01
5994946001
CIGNA
RI
01
7614070
AETNA-NON HMO
RI
01
J11772
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/27/2006
Last updated
07/08/2007
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