Dr. Shana Domonique Talbot, MD
Student in an Organized Health Care Education/Training Program in Providence, RI. Individual provider (NPI-1).
NPI number1033859129
StatusActive
Last updated in NPPESMar 29, 2022
Details
- NPI
- 1033859129
- Entity type
- Individual (NPI-1)
- Name
- Dr. Shana Domonique Talbot
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 29, 2022
- Certification date
- Mar 29, 2022
- Last updated
- Mar 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
101 Dudley StProvidence, RI 02905-2499
Phone 917-941-4392
Mailing address
2347 Tiebout Ave Apt 5aBronx, NY 10458-7354
Phone 917-941-4392
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