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NPI Code Detail

MEDICARE: MR. ANDRE ROBERT CARPENTIER IDC

MEDICARE:  MR. ANDRE ROBERT CARPENTIER  IDC
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
11710I1002XIndependent Duty Corpsman

General Provider Information

NPI Number : 1093828857
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDRE ROBERT CARPENTIER IDC
Provider Business Mailing Address
First Line : 16 BARTON ST
Second Line :
City : WOONSOCKET
State : RI
Zip : 02895-1106
Country : US
Telephone Number : 401-765-8667
Fax Number : 860-694-3874
Provider Business Practice Location Address
First Line : USS MIAMI SSN-755
Second Line :
City : FPO
State : AE
Zip : 09578-2411
Country : US
Telephone Number : 860-694-3834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 12/10/2008

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Directions to “ MR. ANDRE ROBERT CARPENTIER IDC” Practice Location

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