Provider Demographics
NPI:1043070253
Name:DUCKWORTH, MEGAN STEFANIA (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:STEFANIA
Last Name:DUCKWORTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-2324
Mailing Address - Country:US
Mailing Address - Phone:617-276-4527
Mailing Address - Fax:
Practice Address - Street 1:101 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2401
Practice Address - Country:US
Practice Address - Phone:401-274-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program