MEDICARE: JAMES T DWYER D.O.

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	207RI0200X	Infectious Disease Physician	290887	MA

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	:	1679551212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES T DWYER D.O.

Provider Business Mailing Address
First Line	:	PO BOX 598
Second Line	:
City	:	HARWICH PORT
State	:	MA
Zip	:	02646-0598
Country	:	US
Telephone Number	:	508-905-2800
Fax Number	:	508-240-1244

Provider Business Practice Location Address
First Line	:	3130 STATE HWY RTE 6
Second Line	:
City	:	WELLFLEET
State	:	MA
Zip	:	02667-7402
Country	:	US
Telephone Number	:	508-349-3131
Fax Number	:	508-487-6298

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	02/29/2024

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