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1720649882
NIDA SHUTTARI
PROVIDENCE, RI
NPI
1720649882
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: RI LP04766)
Enumeration Date
2019-06-27
Last Update Date
2019-07-28
Business Address
NIDA SHUTTARI MD
825 CHALKSTONE AVE
PROVIDENCE, RI 02908-4728
Phone number: 401-456-2000
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Mailing Address
NIDA SHUTTARI MD
825 CHALKSTONE AVE
PROVIDENCE, RI 02908-4728
Phone number:
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