Provider Demographics
NPI:1871588947
Name:CARON, PIERRE A (MD)
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:A
Last Name:CARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:215 TOLL GATE RD STE 104
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4463
Practice Address - Country:US
Practice Address - Phone:401-921-7290
Practice Address - Fax:401-921-6194
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD061067L207Q00000X
RIMD18319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA820796OtherHIGHMARK BLUE SHIELD
PAG50905Medicare UPIN
PA35766 S1QBOtherGEISINGER HEALTH PLAN
PA0016606050001Medicaid
PAG50905OtherHEALTH ASSURANCE
PA820796JZEMedicare PIN
PA820796OtherHIGHMARK BLUE SHIELD
PA02143001OtherCAPITAL BLUE CROSS
PAP004739OtherGATEWAY HEALTH PLAN
PAG50905Medicare UPIN