Organization · Type 2 NPI

The Miriam Hospital

Surgery Physician · Providence, RI

NPI number 1902133481 Active

Practice location

164 Summit Ave, Gilstein Suite/baxt Bldg 1st Floor
Providence, RI 02906-2853

Call (401) 793-4612 Map

Mailing address

15 La Salle Sq
Providence, RI 02903-1814

Specialties and licenses

Taxonomy	Code	License
Surgery Physician Primary	208600000X	None listed

Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…

285 other providers at this address

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NPI record

NPI: 1902133481
Entity type: Organization (Type 2)
Issued: Nov 4, 2009
Last updated: Dec 11, 2025
Status: Active

Other names

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The Miriam Hospital Department of Surgery · doing business as
The Miriam Hospital Department of Surgery · doing business as

Authorized official

Peter K Markell
E VP & CFO
(401) 444-7914

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1902133481

The Miriam Hospital's National Provider Identifier is 1902133481, issued on Nov 4, 2009. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Providence, RI. The record was last updated on Dec 11, 2025.