Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 248913 | MA |
N | 208000000X | Pediatrician | MD14618 | RI |
Y | 2080P0204X | Pediatric Emergency Doctor | MD14618 | RI |
NPI | 1134355936 |
---|---|
Provider Name | Robyn D. Wing |
First Address | Providence, RI 02903-4923 |
Second Address | Providence, RI 02903-4923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 29/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110094356A | (05) | MA |