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NPI Code Detail

MEDICARE: DR. DAVID JOHN WYLER M.D.

MEDICARE: DR. DAVID JOHN WYLER 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
1207R00000XInternal Medicine Physician44458MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1700522OTHERMATUFTS HEALTH PLAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3V05362OTHERMABCBS
4694789OTHERMAHARVARD PILGRIM HEALTH PL

General Provider Information

NPI Number : 1689657686
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID JOHN WYLER M.D.
Provider Business Mailing Address
First Line : 2291 WASHINGTON ST
Second Line : APT. G
City : NEWTON
State : MA
Zip : 02462-1426
Country : US
Telephone Number : 617-964-3960
Fax Number : 617-527-6737
Provider Business Practice Location Address
First Line : 2014 WASHINGTON ST
Second Line : HOSPITALIST SERVICE, 2 NORTH
City : NEWTON
State : MA
Zip : 02462-1607
Country : US
Telephone Number : 617-243-6000
Fax Number : 617-527-6737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 07/08/2007

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Directions to “ DR. DAVID JOHN WYLER M.D.” Practice Location

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