Individual
CHARLES B. EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 BREWSTER ST, DEPARTMENT OF FAMILY MEDICINE, PAWTUCKET, RI 02860-4400
(401) 729-2237
(401) 729-2923
Mailing address
111 BREWSTER ST, DEPARTMENT OF FAMILY MEDICINE, PAWTUCKET, RI 02860-4400
(401) 729-2237
(401) 729-2923
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD07802
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007057389
MEDICARE PTAN
RI
05
—
9006954
—
RI
Enumeration date
11/23/2005
Last updated
05/13/2010
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