Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 261074 | MA |
Y | 207RN0300X | Nephrologist | MD14328 | RI |
NPI | 1013189174 |
---|---|
Provider Name | Eric Scott Kerns |
First Address | Providence, RI 02903-4626 |
Second Address | Burlington, MA 01805-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2008 |
Last Update Date | 06/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110103802A | (05) | MA |