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NPI Code Detail

MEDICARE: DR. SHENIQUE ANDERSON WESLEY M.D.

MEDICARE: DR. SHENIQUE ANDERSON WESLEY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME160932FL
2207QA0505XAdult Medicine Physician077698GA
3208M00000XHospitalist Physician077698GA
4207Q00000XFamily Medicine PhysicianT7389TX
5207QA0505XAdult Medicine PhysicianT7389TX
6207QA0505XAdult Medicine PhysicianME160932FL
7207Q00000XFamily Medicine Physician77698GA

General Provider Information

NPI Number : 1912256892
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHENIQUE ANDERSON WESLEY M.D.
Provider Business Mailing Address
First Line : PO BOX 290915
Second Line :
City : EL PASO
State : TX
Zip : 79929-0915
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 CEDAR ST
Second Line :
City : METTER
State : GA
Zip : 30439-3338
Country : US
Telephone Number : 912-685-5741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2012
Last Update Date : 03/19/2026

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