Provider Demographics
NPI:1518256718
Name:HOWARD, MEMAH (PA-C)
Entity Type:Individual
Prefix:
First Name:MEMAH
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 ATWOOD AVENUE
Mailing Address - Street 2:STE 220
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-272-1900
Mailing Address - Fax:401-453-3049
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:STE 220
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-272-1900
Practice Address - Fax:401-453-3049
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIPA00583363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical