Individual provider · NPI-1

Matilda Addo, MD

Family Medicine · Pawtucket, RI

NPI number1649383241
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1649383241
Entity type
Individual (NPI-1)
Name
Matilda Addo
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Aug 16, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineLP00093RIYes

Practice location

111 Brewster Street
Fcc Team B
Pawtucket, RI 02860

Phone 401-729-2206 · Fax 401-729-3495

Mailing address

111 Brewster Street
Fcc Team B
Pawtucket, RI 02860

Phone 401-729-2206 · Fax 401-729-3495

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