MEDICARE: PIERRE A CARON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD061067L	PA
2	207Q00000X	Family Medicine Physician	MD18319	RI

General Provider Information

NPI Number	:	1871588947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERRE A CARON MD

Provider Business Mailing Address
First Line	:	455 TOLL GATE RD
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-2759
Country	:	US
Telephone Number	:	401-273-0641
Fax Number	:	401-273-2919

Provider Business Practice Location Address
First Line	:	215 TOLL GATE RD STE 104
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-4463
Country	:	US
Telephone Number	:	401-921-7290
Fax Number	:	401-921-6194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	05/09/2022

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Directions to “ PIERRE A CARON MD” Practice Location

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