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NPI Code Detail

MEDICARE: CANDACE THEAL WESTGATE DO

MEDICARE: CANDACE THEAL WESTGATE DO
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
1207V00000XObstetrics & Gynecology Physician02008232AIN
2207V00000XObstetrics & Gynecology Physician20A 12684CA

General Provider Information

NPI Number : 1669607735
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE THEAL WESTGATE DO
Provider Business Mailing Address
First Line : 6626 E 75TH ST STE 500
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7120 CLEARVISTA DR STE 2000
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1548
Country : US
Telephone Number : 317-621-7120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2009
Last Update Date : 02/27/2025

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Directions to “ CANDACE THEAL WESTGATE DO” Practice Location

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