MORDECAI JEREMIAH STOLK


Address: 318 Waterman Ave, East Providence, RI 02914-3525
Phone: 4014385950

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
RI 1124225594 05
RI RI BLUE CROSS 1124225594 01
MA BLUE CROSS OF MASS 1124225594 01

Office Location

Street Address 318 WATERMAN AVE
City EAST PROVIDENCE
State RI
Zip Code 02914-3525

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 207RN0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Nephrology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City EAST PROVIDENCE
Zip Code 02914

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Dataset Information

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.

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