Provider Demographics
NPI:1134431257
Name:CARPENTER, ELISE (MD)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:360 MERRIMACK ST STE 9
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1764
Mailing Address - Country:US
Mailing Address - Phone:978-655-6652
Mailing Address - Fax:978-984-7384
Practice Address - Street 1:360 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1740
Practice Address - Country:US
Practice Address - Phone:978-655-6652
Practice Address - Fax:978-655-6653
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2022-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA256427207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine