Healthcare Provider Details

I. General information

NPI: 1295003226
Provider Name (Legal Business Name): SELMA YAVUZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SELMA DEMIR MD

II. Dates (important events)

Enumeration Date: 12/05/2011
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 WAMPANOAG TRL
RIVERSIDE RI
02915-2232
US

IV. Provider business mailing address

DEPT 3010, PO BOX 986524
BOSTON MA
02298-6524
US

V. Phone/Fax

Practice location:
  • Phone: 401-649-4010
  • Fax: 401-649-4011
Mailing address:
  • Phone: 401-443-4992
  • Fax: 401-784-4913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number64252
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number64252
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD20720
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: