Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 0101028577 | VA |
NPI | 1023015229 |
---|---|
Provider Name | Stewart James Wetchler |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23298-0510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 17/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023015229 | (05) | VA |
B09300 | (02) | VA |