Healthcare Provider Details
I. General information
NPI: 1902853997
Provider Name (Legal Business Name): WILLIAM ADOLPH WEWER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/27/2006
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 S FRONT ST
STEELTON PA
17113-2319
US
IV. Provider business mailing address
7 DOCK HILL RD
MIDDLEBURG PA
17842-8910
US
V. Phone/Fax
- Phone: 717-939-9831
- Fax: 717-986-1703
- Phone: 570-837-2123
- Fax: 570-837-2185
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS004413L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: