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General NPI Number Information
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NPI Number | 1134138092
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Entity Type | Individual
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Provider Name | HOWARD JOHN WETTERER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | AVE. GENERAL VALERO 313 SUITE A
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City | FAJARDO
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State | PR
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Zip | 00738-4732
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Country | US
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Telephone | 787-801-3158
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Fax | 787-801-3159
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Provider Business Mailing Address
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Address Line | 426 CALLE SAN GENARO URB. SAGRADO CORAZON
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City | SAN JUAN
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State | PR
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Zip | 00926-4220
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Country | US
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Telephone | 787-801-3158
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Fax | 787-801-3159
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 14536
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License Number State | PR
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