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Individual

MS. JOANN PATRICIA DWELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RFM

Contact information

Practice address
177 SONGBIRD LN, TIVERTON, RI 02878-2382
(401) 835-1797
Mailing address
177 SONGBIRD LN, TIVERTON, RI 02878-2382
(401) 835-1797
(508) 636-4447

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26904-9
BLUE CROSS/BLUE SHIELD
RI
01
411281
BLUE CHIP
RI
01
706247
HARVARD PILGRIM HEALTH
MA
01
820956
TUFTS HEALTH PLAN
MA
Enumeration date
07/07/2005
Last updated
10/10/2023
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