Healthcare Provider Details

I. General information

NPI: 1992796106
Provider Name (Legal Business Name): RENEE ROSS EGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 11/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 PLAIN ST SUITE 401
PROVIDENCE RI
02905-3240
US

IV. Provider business mailing address

235 PLAIN ST SUITE 401
PROVIDENCE RI
02905-3240
US

V. Phone/Fax

Practice location:
  • Phone: 401-342-1171
  • Fax: 401-861-2164
Mailing address:
  • Phone: 401-342-1171
  • Fax: 401-861-2164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number8636
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number82040
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: