Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD6865 | RI |
NPI | 1194756379 |
---|---|
Provider Name | Stephen Carr |
First Address | Providence, RI 02905-2401 |
Second Address | Providence, RI 02905-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 28/09/2011 |