Organization
THE MIRIAM HOSPITAL
Active
Parent organization
LIFESPAN CORPORATION
Other names
The Miriam Hospital Professional Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFESPAN CORPORATION
Authorized official
PETER K MARKELL (E VP & CFO)
(401) 444-7914
Entity
Organization
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 444-5640
(401) 444-5462
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZM0300X
Medical Microbiology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
208600000X
Surgery Physician
—
—
261Q00000X
Clinic/Center
HOS00122
RI
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
05/07/2007
Last updated
03/18/2026
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