Individual
DR. ANDREA SHANNON PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
220 BELLEVUE AVE, NEWPORT, RI 02840-3515
(401) 849-0410
Mailing address
40 3RD ST, APT 2, PROVIDENCE, RI 02906-2727
(317) 417-1114
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD14355
RI
390200000X
Student in an Organized Health Care Education/Training Program
11014450A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/30/2008
Last updated
07/31/2013
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