Healthcare Provider Details

I. General information

NPI: 1700817269
Provider Name (Legal Business Name): BRETT DAVID KALMOWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 W RIVER ST
PROVIDENCE RI
02904-2609
US

IV. Provider business mailing address

PO BOX 202230
DALLAS TX
75320-2230
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-4800
  • Fax: 401-454-0410
Mailing address:
  • Phone: 401-274-4800
  • Fax: 401-454-0410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number210642
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD12041
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: