Provider Demographics
NPI:1164658027
Name:SOLBERG, MONISSA J (MD)
Entity Type:Individual
Prefix:DR
First Name:MONISSA
Middle Name:J
Last Name:SOLBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:334 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909
Mailing Address - Country:US
Mailing Address - Phone:401-437-4116
Mailing Address - Fax:401-223-5838
Practice Address - Street 1:334 BROADWAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909
Practice Address - Country:US
Practice Address - Phone:401-437-4116
Practice Address - Fax:401-223-5838
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1073042084P0800X
RIMD145742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry