Individual
DR. BRETT W. GOUDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 HOPPIN ST, CORO BUILDING, PROVIDENCE, RI 02903-4141
(401) 444-4612
(401) 793-8831
Mailing address
593 EDDY ST, HASBRO 122, PROVIDENCE, RI 02903-4923
(401) 444-4612
(401) 793-8831
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
C10008082
DE
2080P0202X
Pediatric Cardiology Physician
D0068007
MD
2080P0202X
Pediatric Cardiology Physician
MD429590
PA
2080P0202X
Pediatric Cardiology Physician
Primary
RI13511
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101712508
—
PA
05
—
109592
—
NJ
05
—
1679627798
—
VA
05
—
4110510
—
MD
Enumeration date
01/23/2007
Last updated
05/03/2011
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