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General NPI Number Information
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NPI Number | 1477618064
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Entity Type | Individual
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Provider Name | MARLA CATHLEEN ANGERMEIER M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 148 W RIVER ST SUITE 1 B
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City | PROVIDENCE
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State | RI
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Zip | 02904-2615
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Country | US
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Telephone | 401-273-9310
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Fax | 401-273-1270
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Provider Business Mailing Address
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Address Line | 526 MAIN ST STE 302
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City | ACTON
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State | MA
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Zip | 01720-3301
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Country | US
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Telephone | 978-371-7010
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Fax | 978-371-0522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 6161
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License Number State | RI
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