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Individual

KYLE DENISON MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O., MA, MPH

Contact information

Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903
(401) 854-2504
(401) 427-7795
Mailing address
125 WHIPPLE STREET, 3RD FLOOR, PROVIDENCE, RI 02908-3258
(401) 854-2504

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101020571
MI
207P00000X
Emergency Medicine Physician
Primary
DC00855
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DC00855
RI LICENSE
RI
Enumeration date
04/08/2013
Last updated
07/21/2022
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