Individual
PHILIP JABEE RIDDLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 793-2500
Mailing address
164 SUMMIT AVE STE 221, PROVIDENCE, RI 02906-2853
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
82730
SC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
LP06227
RI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/06/2019
Last updated
07/01/2024
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