Individual
SUBHANKAR MAITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903
(401) 444-3985
(401) 444-3986
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD14223
RI
Other
Enumeration date
03/12/2010
Last updated
07/31/2018
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