MEDICARE: ANNE M HEBERT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	RI64887	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	202053	OTHER	RI	BLUE CHIP
2	20390	OTHER	RI	BLUE CROSS

General Provider Information

NPI Number	:	1144227018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE M HEBERT MD

Provider Business Mailing Address
First Line	:	360 KINGSTOWN RD
Second Line	:	STE 207
City	:	NARRAGANSETT
State	:	RI
Zip	:	02882-3239
Country	:	US
Telephone Number	:	401-789-0774
Fax Number	:	401-789-1355

Provider Business Practice Location Address
First Line	:	360 KINGSTOWN RD
Second Line	:	STE 207
City	:	NARRAGANSETT
State	:	RI
Zip	:	02882-3239
Country	:	US
Telephone Number	:	401-789-0774
Fax Number	:	401-789-1355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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