Provider Demographics
NPI:1417926890
Name:SOMVANSHI, NICOLE P (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:P
Last Name:SOMVANSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:STE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4752
Mailing Address - Country:US
Mailing Address - Phone:401-539-0283
Mailing Address - Fax:401-539-6741
Practice Address - Street 1:1598 S COUNTY TRL STE 115
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1762
Practice Address - Country:US
Practice Address - Phone:401-884-0333
Practice Address - Fax:401-884-0096
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2024-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD11818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1417926890Medicaid