MEDICARE: DR. CARYN MCNANEY WEST OD

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	152W00000X	Optometrist	SC0890	SC

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	:	1356390652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARYN MCNANEY WEST OD

Provider Business Mailing Address
First Line	:	211 N WASHINGTON ST
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-4204
Country	:	US
Telephone Number	:	803-775-9314
Fax Number	:	803-773-8381

Provider Business Practice Location Address
First Line	:	211 N WASHINGTON ST
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-4204
Country	:	US
Telephone Number	:	803-775-9314
Fax Number	:	803-773-8381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2006
Last Update Date	:	06/29/2011

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