Provider Demographics
NPI:1356390652
Name:WEST, CARYN MCNANEY (OD)
Entity type:Individual
Prefix:DR
First Name:CARYN
Middle Name:MCNANEY
Last Name:WEST
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4204
Mailing Address - Country:US
Mailing Address - Phone:803-775-9314
Mailing Address - Fax:803-773-8381
Practice Address - Street 1:211 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4204
Practice Address - Country:US
Practice Address - Phone:803-775-9314
Practice Address - Fax:803-773-8381
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC0890152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD08900Medicaid
SC4791350001Medicare NSC
410047050Medicare PIN
SCD08900Medicaid