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General NPI Number Information
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NPI Number | 1629497870
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Entity Type | Individual
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Provider Name | DAVID THOMAS WYMER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 09/07/2025
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Provider Practice Location Address
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Address Line | 3100 WESTON RD
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City | WESTON
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State | FL
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Zip | 33331-3602
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Country | US
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Telephone | 216-636-8316
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Fax | 216-636-6036
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Provider Business Mailing Address
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Address Line | 3100 WESTON RD
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City | WESTON
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State | FL
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Zip | 33331-3602
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Country | US
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Telephone |
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036.148590
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 130714
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License Number State | FL
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