Graduated: 1989
NPI: 1053399105
Practice Locations (3)
LIFESPAN PHYSICIAN GROUP INC
185 A HIGH SERVICE AVE
NORTH PROVIDENCE, RI 029045114
4013546050
LIFESPAN PHYSICIAN GROUP INC
185 HIGH SERVICE AVE
NORTH PROVIDENCE, RI 029045114
4013546050
LIFESPAN PHYSICIAN GROUP INC
164 SUMMIT AVE
PROVIDENCE, RI 029062853
Source: CMS National Downloadable File, September 2026.