MEDICARE: DR. JAMES STEPHEN WECHSLER PH.D.,M.D.

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	39053	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	039053	OTHER	MA	TUFTS MEDICARE PREFERRED

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0029992	OTHER	MA	NEIGHBORHOOD HEALTH
2	039053	OTHER	MA	TUFTS HEALTH PLAN
3	C27073	OTHER	MA	BLUE SHIELD
5	34451	OTHER	MA	BOSTON MEDICAL CENTER
6	36686	OTHER	MA	FALLON
7	275189	OTHER	MA	HARVARD PILGRIM
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639164460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES STEPHEN WECHSLER PH.D.,M.D.

Provider Business Mailing Address
First Line	:	163 LIBBEY INDUSTRIAL PKWY
Second Line	:	SUITE 301
City	:	EAST WEYMOUTH
State	:	MA
Zip	:	02189-3101
Country	:	US
Telephone Number	:	781-337-4224
Fax Number	:	781-335-0429

Provider Business Practice Location Address
First Line	:	163 LIBBEY INDUSTRIAL PKWY
Second Line	:	SUITE 301
City	:	EAST WEYMOUTH
State	:	MA
Zip	:	02189-3101
Country	:	US
Telephone Number	:	781-337-4224
Fax Number	:	781-335-0429

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	06/13/2008

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