MEDICARE: WESLEY MESSER NORWOOD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	71812541206	UT

General Provider Information

NPI Number	:	1457597809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY MESSER NORWOOD PA

Provider Business Mailing Address
First Line	:	150 S 1000 E STE 200
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1496
Country	:	US
Telephone Number	:	801-363-4071
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 S 1000 E STE 200
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1496
Country	:	US
Telephone Number	:	801-363-4071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2009
Last Update Date	:	03/24/2009

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Directions to “ WESLEY MESSER NORWOOD PA” Practice Location

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