Provider Demographics
NPI:1114905528
Name:SMIGEL, KAREN R (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:R
Last Name:SMIGEL
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:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02880-0229
Mailing Address - Country:US
Mailing Address - Phone:401-788-3929
Mailing Address - Fax:401-788-3939
Practice Address - Street 1:900 WARREN AVE STE 400
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1430
Practice Address - Country:US
Practice Address - Phone:401-331-1221
Practice Address - Fax:401-751-8003
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD08511207Q00000X
MA75132207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1114905528Medicaid
MAF14294Medicare UPIN
MAJ11905Medicare UPIN
J1190501Medicare PIN
MA712936OtherHARVARD PILGRIM
MAM20518Medicare PIN
MA2014629Medicaid
MA075312OtherTUFTS HEALTH PLAN