Provider Demographics
NPI:1144296054
Name:DAVID CARPENTIER, MD FAMILY HEALTHCARE LTD
Entity type:Organization
Organization Name:DAVID CARPENTIER, MD FAMILY HEALTHCARE LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:FAIRWEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-943-4540
Mailing Address - Street 1:495 ATWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-5316
Mailing Address - Country:US
Mailing Address - Phone:401-943-4540
Mailing Address - Fax:401-944-7727
Practice Address - Street 1:495 ATWOOD AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5316
Practice Address - Country:US
Practice Address - Phone:401-943-4540
Practice Address - Fax:401-944-7727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI6600011OtherUNITED HEALTH
RI405619OtherBLUE CHIP
RI2949#4OtherBCBS
RI019002949OtherMEDICARE PTAN