Healthcare Provider Details

I. General information

NPI: 1861429524
Provider Name (Legal Business Name): LARRY H WEXLER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33566 W 8 MILE RD SUITE C
FARMINGTON HILLS MI
48335-5271
US

IV. Provider business mailing address

33566 W 8 MILE RD SUITE C
FARMINGTON HILLS MI
48335-5271
US

V. Phone/Fax

Practice location:
  • Phone: 248-476-5288
  • Fax:
Mailing address:
  • Phone: 248-476-5288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0940
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: