Individual
SHIJO BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5033
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5033
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
LP06476
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
03/31/2022
Last updated
06/26/2025
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