Healthcare Provider Details
I. General information
NPI: 1568495877
Provider Name (Legal Business Name): WESTFIELD FAMILY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
115 EAST MAIN STREET
SHERMAN NY
14781
US
IV. Provider business mailing address
115 EAST MAIN STREET PO BOX 570
SHERMAN NY
14781
US
V. Phone/Fax
- Phone: 716-326-4678
- Fax: 716-326-4914
- Phone: 716-326-4678
- Fax: 716-326-4914
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DONALD
FRANK
BRAUTIGAM
Title or Position: CEO
Credential: MD
Phone: 716-326-4678