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Individual

KEVIN P CHARPENTIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
680 CENTRE ST, BROCKTON, MA 02302
(508) 941-7000
(508) 941-0895
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7885
(508) 941-6337

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
041519
CT
204F00000X
Transplant Surgery Physician
MD12241
RI
208600000X
Surgery Physician
041519
CT
208600000X
Surgery Physician
Primary
277097
MA
208600000X
Surgery Physician
MD12241
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7059024
RI
Enumeration date
07/19/2005
Last updated
06/28/2019
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