Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 34387 | MA |
NPI | 1265540975 |
---|---|
Provider Name | Michael D Wertheimer |
First Address | Westwood, MA 02090-2161 |
Second Address | Worcester, MA 01605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 20/07/2015 |