Individual provider · NPI-1

Maggie Bacon, MB BCh BAO

Emergency Medicine · Warwick, RI

NPI number1710506274
StatusActive
Last updated in NPPESMay 22, 2024

Details

NPI
1710506274
Entity type
Individual (NPI-1)
Name
Maggie Bacon
Credential
MB BCh BAO
Sex
Female
Sole proprietor
No
Enumeration date
Apr 14, 2020
Certification date
May 22, 2024
Last updated
May 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency MedicineMD19876RIYes

Practice location

455 Toll Gate Rd
Warwick, RI 02886-2759

Phone 401-737-7010

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759

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