Provider Demographics
NPI:1285669275
Name:CARREAU, GAIL E (MD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:E
Last Name:CARREAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GAIL
Other - Middle Name:C
Other - Last Name:VENUTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:19 FRIENDSHIP ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2272
Mailing Address - Country:US
Mailing Address - Phone:401-848-5556
Mailing Address - Fax:401-519-2994
Practice Address - Street 1:19 FRIENDSHIP ST
Practice Address - Street 2:SUITE 220
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2272
Practice Address - Country:US
Practice Address - Phone:401-848-5556
Practice Address - Fax:401-519-2994
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037283207V00000X
RIMD14775207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0175967OtherSTATE L&I
WA1098789Medicaid
WA0131277OtherSTATE L&I
WA160045733OtherMEDICARE RAILROAD
WA8931160OtherSTATE CRIME VICTIMS
WA1098789Medicaid
WAGAB40004Medicare PIN
WAGAB13415Medicare PIN