Provider Demographics
NPI:1821015702
Name:TOWNSEND, KIMBERLEY (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:TOWNSEND
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 1:450 VETERANS MEMORIAL PKWY
Mailing Address - Street 2:BLDG. 10
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-5300
Mailing Address - Country:US
Mailing Address - Phone:401-438-6888
Mailing Address - Fax:401-434-1285
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY
Practice Address - Street 2:BLDG. 10
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5300
Practice Address - Country:US
Practice Address - Phone:401-438-6888
Practice Address - Fax:401-434-1285
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD9132208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI400287OtherBLUE CHIP INSURANCE
RI406193OtherTUFTS INSURANCE
RIAA48220OtherHARVARD PILGRIM
RIMD09132OtherBLUE CROSS
RI1200492OtherUNITED HEALTH CARE
RIKT17123Medicaid
RIAA48220OtherHARVARD PILGRIM