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NPI Code Detail

MEDICARE: SUSAN M WENTE CNM

MEDICARE: SUSAN M WENTE CNM
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
1367A00000XAdvanced Practice Midwife210876MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659356269
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN M WENTE CNM
Provider Business Mailing Address
First Line : 63 MAIN ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-4042
Country : US
Telephone Number : 508-559-6699
Fax Number : 508-583-4649
Provider Business Practice Location Address
First Line : 63 MAIN ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-4042
Country : US
Telephone Number : 508-559-6699
Fax Number : 508-583-4649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 12/16/2011

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Directions to “ SUSAN M WENTE CNM” Practice Location

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