MEDICARE: WEST BAY SURGICAL ASSOCIATES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician		RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174522304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST BAY SURGICAL ASSOCIATES INC.

Provider Business Mailing Address
First Line	:	390 TOLL GATE RD
Second Line	:	STE.200
City	:	WARWICK
State	:	RI
Zip	:	02886-4326
Country	:	US
Telephone Number	:	401-739-8010
Fax Number	:	401-739-6087

Provider Business Practice Location Address
First Line	:	390 TOLL GATE RD
Second Line	:	STE.200
City	:	WARWICK
State	:	RI
Zip	:	02886-4326
Country	:	US
Telephone Number	:	401-739-8010
Fax Number	:	401-739-6087

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CANDACE L. DYER
Credential	:	M.D.
Telephone Number	:	401-739-8010

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	07/21/2022

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Directions to “WEST BAY SURGICAL ASSOCIATES INC. ” Practice Location

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