Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD11139 | RI |
Y | 208600000X | Surgeon | MD11139 | RI |
N | 2086X0206X | Surgical Oncologist | MD11139 | RI |
NPI | 1356349518 |
---|---|
Provider Name | Thomas J. Miner |
First Address | Rumford, RI 02916-0697 |
Second Address | Providence, RI 02905-3236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 29/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2018381 | (05) | MA |
9026575 | (05) | RI |
H88069 | (02) |