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General NPI Number Information
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NPI Number | 1689692592
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Entity Type | Individual
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Provider Name | PHILIP H STOCKWELL MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 950 WARREN AVE 2ND FLOOR
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-1432
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Country | US
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Telephone | 401-606-1004
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Fax | 401-606-1153
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Provider Business Mailing Address
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Address Line | 117 ELLENFIELD ST SUITE 101
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City | PROVIDENCE
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State | RI
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Zip | 02905-4513
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Country | US
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Telephone | 401-444-4318
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Fax | 401-444-6573
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD10603
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | MD10603
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License Number State | RI
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