Graduated: 1990
NPI: 1851596704
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
2 DUDLEY ST
PROVIDENCE, RI 029053248
4012721800
Source: CMS National Downloadable File, September 2026.