SHORELINE PODIATRY LLC NPI 1740216035

NPI Information

SHORELINE PODIATRY, LLC is a foot and ankle surgery podiatrist in Wakefield, RI. SHORELINE PODIATRY, LLC NPI is 1740216035. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

24 SALT POND RD
UNIT E-1
WAKEFIELD, RI
ZIP 02879-314
Phone: (401) 783-2424
Fax: (401) 789-2095

The provider's authorized official is James I Mccormick .
The authorized official title is President and has the following contact phone number (401) 783-2424.

The CLIA number assigned to this NPI record is 41D0915635 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/25/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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