Individual
LORETTA M. MARION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
355 PRAIRIE AVE, PROVIDENCE, RI 02905-1928
(401) 444-0570
(401) 444-0427
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 780-2511
(401) 780-2565
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
DO01075
RI
208000000X
Pediatrics Physician
DO37583
SC
208000000X
Pediatrics Physician
OS007739L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001592004
—
PA
Enumeration date
04/26/2006
Last updated
12/14/2023
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