Individual
DONNELLA SIMONE COMEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
525 BROAD ST, ADVANCED RADIOLOGY, CUMBERLAND, RI 02864-6919
(401) 725-6736
Mailing address
190 ELMGROVE AVE, PROVIDENCE, RI 02906-4233
(781) 962-8621
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
223820
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD12003
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2112710
—
MA
01
—
294444
TUFTS HEALTH CARE
MA
01
—
J29652
BLOE CROSS BLUE SHIELD
MA
Enumeration date
01/19/2006
Last updated
07/08/2007
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