Provider Demographics
NPI:1043447097
Name:UMMARITCHOT, VORAWAN (MD)
Entity Type:Individual
Prefix:MISS
First Name:VORAWAN
Middle Name:
Last Name:UMMARITCHOT
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 1:100 HIGHLAND AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2740
Mailing Address - Country:US
Mailing Address - Phone:401-351-7100
Mailing Address - Fax:401-751-6179
Practice Address - Street 1:100 HIGHLAND AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2740
Practice Address - Country:US
Practice Address - Phone:401-351-7100
Practice Address - Fax:401-751-6179
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD14531207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism