Individual
CRAIG P. EBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 DUDLEY ST, STE 200, PROVIDENCE, RI 02905-3236
(401) 457-1550
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
(401) 457-1550
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
10364
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000221
—
RI
Enumeration date
04/20/2006
Last updated
08/25/2014
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