Provider Demographics
NPI:1942528658
Name:DYER, MARGARET M (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:DYER
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 1:100 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2740
Mailing Address - Country:US
Mailing Address - Phone:401-633-1100
Mailing Address - Fax:401-633-0047
Practice Address - Street 1:100 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2740
Practice Address - Country:US
Practice Address - Phone:401-633-1100
Practice Address - Fax:401-633-0047
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD15188208000000X
CT052343208000000X
MA257174208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics