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General NPI Number Information
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NPI Number | 1639249956
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Entity Type | Individual
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Provider Name | J S TODER
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 1524 ATWOOD AVE
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City | JOHNSTON
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State | RI
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Zip | 02919-3228
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Country | US
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Telephone | 401-421-6011
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Fax | 401-421-9088
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Provider Business Mailing Address
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Address Line | PO BOX 6300
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City | PROVIDENCE
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State | RI
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Zip | 02940-6300
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Country | US
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Telephone | 401-421-6011
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Fax | 401-421-9088
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD6321
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License Number State | RI
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