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General NPI Number Information
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NPI Number | 1841354982
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Entity Type | Organization
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Legal Business Name | WEST BAY DERMATOLOGY, LTD
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 1672 S COUNTY TRL STE 202
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City | EAST GREENWICH
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State | RI
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Zip | 02818-5099
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Country | US
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Telephone | 401-885-4100
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Fax | 401-885-4130
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Provider Business Mailing Address
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Address Line | 1672 S COUNTY TRL STE 202
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City | EAST GREENWICH
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State | RI
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Zip | 02818-5099
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Country | US
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Telephone | 401-885-4100
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Fax | 401-885-4130
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Authorized Official
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Title or Position | PARTNER
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Name | DR. CAROLINE S WILKEL
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Credential | M.D.
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Telephone | 401-885-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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