Provider Demographics
NPI:1942379086
Name:CARPENTIER, DAVID (07744)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:CARPENTIER
Suffix:
Gender:M
Credentials:07744
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 ATWOOD AVE
Mailing Address - Street 2:CRANSTON MEDICAL,INC
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:CRANSTON MEDICAL,INC
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI07744261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007007462Medicare ID - Type Unspecified
RIF22411Medicare UPIN