Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD065137L | PA |
NPI | 1013950583 |
---|---|
Provider Name | Andrew S Wechsler |
First Address | Philadelphia, PA 19102-1321 |
Second Address | Philadelphia, PA 19102-1121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 15/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C87054 | (02) | PA |