Healthcare Provider Details

I. General information

NPI: 1750183687
Provider Name (Legal Business Name): MARVIN B PIERRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY STREET DAVOL 129
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

20 NEWMAN AVE 3-3514
RUMFORD RI
02916-1960
US

V. Phone/Fax

Practice location:
  • Phone: 401-606-4286
  • Fax:
Mailing address:
  • Phone: 516-302-5415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberCLP07079
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: