Provider Demographics
NPI:1205920188
Name:WAY, CHRISTOPHER CARR (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CARR
Last Name:WAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1150 RESERVOIR AVENUE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920
Mailing Address - Country:US
Mailing Address - Phone:401-942-0210
Mailing Address - Fax:401-943-4240
Practice Address - Street 1:1150 RESERVOIR AVENUE
Practice Address - Street 2:SUITE 204
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-942-0210
Practice Address - Fax:401-943-4240
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD06752207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7002136Medicaid
RI7002136Medicaid
RI007002136Medicare PIN