Individual
THANKAM PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-8306
(401) 444-8748
Mailing address
593 EDDY ST, HASBRO 122, PROVIDENCE, RI 02903-4923
(401) 444-6484
(401) 444-6378
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
11704
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TP56568
—
RI
Enumeration date
05/22/2006
Last updated
02/01/2008
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