Individual
MACY RODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 KENYON AVE, WAKEFIELD, RI 02879-4216
(401) 782-8000
Mailing address
770 KAPIOLANI BLVD, HONOLULU, HI 96813-5212
(808) 597-8791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
AMD-1238
HI
363A00000X
Physician Assistant
Primary
PA01394
RI
Other
Enumeration date
09/03/2021
Last updated
08/19/2025
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