Provider Demographics
NPI:1245927227
Name:WEST BAY MEDICAL CENTER PLLC
Entity type:Organization
Organization Name:WEST BAY MEDICAL CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHRESTHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-430-2167
Mailing Address - Street 1:2547 GLEN EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-9316
Mailing Address - Country:US
Mailing Address - Phone:989-430-2167
Mailing Address - Fax:989-686-5920
Practice Address - Street 1:3720 KATALIN CT
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2106
Practice Address - Country:US
Practice Address - Phone:989-686-2800
Practice Address - Fax:989-686-5920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty