Individual
KERI TILMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11 FRIENDSHIP ST, NEWPORT, RI 02840-2209
(401) 845-1593
(401) 847-0650
Mailing address
125 WHIPPLE ST, 3RD FLOOR, PROVIDENCE, RI 02908-3258
(401) 854-2504
(401) 427-7795
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD12106
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110100566A
MASS MEDICAID
RI
01
—
1740201854
NPI
—
01
—
6743-2
BLUE CROSS
RI
05
—
7058778
—
RI
01
—
U400167702
MEDICARE NGS
RI
Enumeration date
07/22/2006
Last updated
02/18/2015
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