Individual
KENNETH H MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
164 SUMMIT AVE, FAIN BLDG., SUITE E, PROVIDENCE, RI 02906-2853
(401) 793-2928
(401) 793-7401
Mailing address
PO BOX 1358, PROVIDENCE, RI 02901-1358
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
44919
MA
207RI0200X
Infectious Disease Physician
Primary
MD06212
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9006201
—
RI
Enumeration date
05/31/2006
Last updated
11/14/2007
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