MEDICARE: SHOELINE 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	174400000X	Specialist	RI6307	RI

General Provider Information

NPI Number	:	1710083043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHOELINE SURGICAL ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	70 KENYON AVE UNIT 325
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4253
Country	:	US
Telephone Number	:	401-284-4114
Fax Number	:	401-789-1358

Provider Business Practice Location Address
First Line	:	70 KENYON AVE UNIT 325
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4253
Country	:	US
Telephone Number	:	401-284-4114
Fax Number	:	401-789-1358

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID COPPE
Credential	:	M.D.
Telephone Number	:	401-284-4114

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1841818259 — DR. PRIYA PATEL MD
Practice Location Address:

70 KENYON AVE STE 270
WAKEFIELD, RI
02879-4253

Practice Phone: 401-782-0090
Practice Fax: 401-782-0888

1265489306 — LEIF ERIC OLSSON M.D.
Practice Location Address:

70 KENYON AVE STE 210
WAKEFIELD, RI
02879-4253

Practice Phone: 401-788-8780
Practice Fax: 401-788-8787

1922099472 — EDWARD B DUGAS MD
Practice Location Address:

70 KENYON AVE UNIT 324
WAKEFIELD, RI
02879-4253

Practice Phone: 401-782-1199
Practice Fax: 401-782-1120

1134176076 — MELINDA K KNIGHT MD
Practice Location Address:

70 KENYON AVE UNIT 324
WAKEFIELD, RI
02879-4253

Practice Phone: 401-788-8780
Practice Fax: 401-788-8787

1700827466 — UMBERTO CAPUANO M.D.
Practice Location Address:

70 KENYON AVE , UNIT 325
WAKEFIELD, RI
02879-4253

Practice Phone: 401-792-7001
Practice Fax: 401-792-7085

1740216381 — LAUREN E MARVELL NP
Practice Location Address:

70 KENYON AVE STE 280
WAKEFIELD, RI
02879-4253

Practice Phone: 401-284-1212
Practice Fax: 401-788-8730

Directions to “SHOELINE SURGICAL ASSOCIATES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.