Provider Demographics
NPI:1760607659
Name:MCATEER, KRISTINA EILEEN (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:EILEEN
Last Name:MCATEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9484
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02940-9484
Mailing Address - Country:US
Mailing Address - Phone:401-854-2500
Mailing Address - Fax:401-854-2519
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-519-1604
Practice Address - Fax:401-272-0538
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP00189207P00000X
RIMD13001207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI12-31-2009OtherBCBSRI
RI04152009OtherUNITED HEALTHCARE
MA110083627AMedicaid
MA10-27-2009OtherTUFTS HEALTH PLAN
RI11-12-2009OtherNHPRI
RI939025129OtherRI MEDICARE GROUP
RIKM77728Medicaid
RI001332201OtherRI MEDICARE