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General NPI Number Information
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NPI Number | 1366898223
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Entity Type | Organization
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Legal Business Name | WEST BAY MEDICAL GROUP, INC
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 215 TOLL GATE RD SUITE 303
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City | WARWICK
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State | RI
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Zip | 02886-4458
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Country | US
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Telephone | 401-468-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 60 LINDSAY LN
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City | CRANSTON
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State | RI
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Zip | 02921-3562
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Country | US
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Telephone | 401-468-8111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUNIL P VERMA
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Credential | MD, MPH
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Telephone | 401-468-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD10322
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License Number State | RI
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