Basic Information
| Provider Information | |||||||||
| NPI: | 1477993160 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOLE-WHITE | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | BROWN | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | KOLE | ||||||||
| OtherFirstName: | MARTHA | ||||||||
| OtherMiddleName: | B | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 101 DUDLEY ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029052401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012730641 | ||||||||
| FaxNumber: | 4012732919 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 DUDLEY ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029052401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012730641 | ||||||||
| FaxNumber: | 4012732919 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2013 | ||||||||
| LastUpdateDate: | 07/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD15804 | RI | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 274082 | MA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VM0101X | 274082 | MA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine | 207VM0101X | MD15804 | RI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
No ID Information.