Healthcare Provider Details

I. General information

NPI: 1992745616
Provider Name (Legal Business Name): PHILIP ANTHONY DINGMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 CHALKSTONE AVE
PROVIDENCE RI
02908-4734
US

IV. Provider business mailing address

894 SHORE RD
POCASSET MA
02559-2064
US

V. Phone/Fax

Practice location:
  • Phone: 401-273-7100
  • Fax: 508-771-0940
Mailing address:
  • Phone: 774-994-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number155915
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number155915
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: