Stolk, Mordecai Jeremiah

Stolk, Mordecai Jeremiah is an individual health care provider with primary practice located at 318 Waterman Ave , East Providence RI 02914-3525. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Stolk, Mordecai Jeremiah can be contacted via phone (401) 438-5950.

Contact Information

Primary practice address
318 Waterman Ave East Providence RI 02914-3525
Phone: (401) 438-5950
Fax: (401) 435-6700
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD13046 Rhode Island
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 241535 Massachusetts

Profile Details

NPI number 1124225594
LBN Legal business name Stolk, Mordecai Jeremiah
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2007
Last updated Oct 29th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124225594 NPPES
Rhode Island Other 1124225594 RI BLUE CROSS
Rhode Island MEDICAID 1124225594 RI BLUE CROSS
Rhode Island Other 1124225594 RI BLUE CROSS

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