MORDECAI JEREMIAH STOLK (NPI# 1124225594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124225594 |
| Entity Type | Individual |
| Full Name | MORDECAI JEREMIAH STOLK |
| Credential | MD |
| Practice Address |
318 Waterman Ave East Providence RI 02914-3525 |
| Practice Telephone | 4014385950 |
| Practice Fax Number | 4014356700 |
| Mailing Telephone | 4014385950 |
| Mailing Fax Number | 4014356700 |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2009-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
241535 | MA | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD13046 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 1124225594 | 05 | |
| RI | RI BLUE CROSS | 1124225594 | 01 |
| MA | BLUE CROSS OF MASS | 1124225594 | 01 |
| Street Address |
318 WATERMAN AVE |
| City | EAST PROVIDENCE |
| State | RI |
| Zip Code | 02914-3525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528052677 | Michael J Monsour | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914-3525 | 2005-09-06 |
| 1770998338 | Manini Vishwanath | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2014-06-23 |
| 1598188088 | Dana Lyn Sarubbi | Dietitian, Registered | 318 Waterman Ave, East Providence, RI 02914-3525 | 2014-02-04 |
| 1083843155 | Prerna Ganjoo | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914-3525 | 2009-07-09 |
| 1184826059 | Lisa Ann Cabral | Dietitian, Registered | 318 Waterman Ave, East Providence, RI 02914-3525 | 2007-06-04 |
| 1770797821 | Ara-rhode Island Dialysis II LLC | Clinic/Center | 318 Waterman Ave, East Providence, RI 02914-3525 | 2007-05-09 |
| 1194837773 | Ara-east Providence Dialysis LLC | Clinic/Center | 318 Waterman Ave, East Providence, RI 02914-3525 | 2006-08-31 |
| 1134192206 | Daniel Lee Dragomire | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914-3525 | 2006-02-09 |
| 1235113358 | George Lee | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-12-01 |
| 1962485490 | Steven B Zipin | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457988198 | Sean C. Duffy | Massage Therapist | 231 Warren Ave., East Providence, RI 02914 | 2020-03-24 |
| 1457905606 | Jeanine Le-kreuzer, Lmhc | Clinic/Center | 3421 Pawtucket Ave, East Providence, RI 02914 | 2019-07-26 |
| 1881113983 | Megan Grace Fitzpatrick | Student in an Organized Health Care Education/Training Program | 51 Milburn Rd, East Providence, RI 02914 | 2017-09-11 |
| 1265719660 | Hilary Elise Bicknell | Physical Therapist | 927 B Warren Ave, East Providence, RI 02914 | 2011-11-14 |
| 1346549037 | Amanda M Hope | Occupational Therapist | 2680 Pawtucket Ave, East Providence, RI 02914 | 2011-03-21 |
| 1780993824 | Shannon Hayes | Physical Therapist | 400 Massaoit Ave, East Providence, RI 02914 | 2010-10-06 |
| 1053623538 | Ricardo Rafael Correa Marquez | Internal Medicine | 900 Warren Avenue, Suite 300, East Providence, RI 02914 | 2010-07-13 |
| 1013231570 | Michael Seidler | Internal Medicine | 20 Catamore Blvd., East Providence, RI 02914 | 2010-03-26 |
| 1053543405 | Ray Rezania | Dentist | 1055 South Broadway, East Providence, RI 02914 | 2009-08-19 |
| 1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
| Find all providers in zip 02914 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770998338 | Manini Vishwanath | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2014-06-23 |
| 1134192206 | Daniel Lee Dragomire | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914-3525 | 2006-02-09 |
| 1235113358 | George Lee | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-12-01 |
| 1962485490 | Steven B Zipin | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-11-29 |
| 1669455192 | Michael A Thursby | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-11-29 |
| 1558344085 | Christopher Joseph Cosgrove | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-11-29 |
| 1720061252 | Joseph A Chazan | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-11-29 |
| 1366426801 | Nephrology Associates Inc | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914-3525 | 2005-11-29 |
| 1922081447 | Charles E Mccoy | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-11-29 |
| 1386628816 | Ildiko Medve | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2005-11-29 |
| Find all providers in EAST PROVIDENCE | ||||
| City | EAST PROVIDENCE |
| Zip Code | 02914 |
Please comment or provide details below to improve the information on MORDECAI JEREMIAH STOLK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.