Healthcare Provider Details

I. General information

NPI: 1932175700
Provider Name (Legal Business Name): PHILIP J WEXLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1465
US

IV. Provider business mailing address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1465
US

V. Phone/Fax

Practice location:
  • Phone: 404-350-4277
  • Fax:
Mailing address:
  • Phone: 404-350-4277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number223916
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD438777
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number223916
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberMD438777
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD438777
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD438777
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: