Provider Demographics
NPI:1093732984
Name:WEXLER, MICHAEL ROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROSS
Last Name:WEXLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12450 WAYZATA BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1978
Mailing Address - Country:US
Mailing Address - Phone:952-546-6566
Mailing Address - Fax:952-512-0038
Practice Address - Street 1:12450 WAYZATA BLVD
Practice Address - Street 2:SUITE 215
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1978
Practice Address - Country:US
Practice Address - Phone:952-546-6566
Practice Address - Fax:952-512-0038
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN28446207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A94328Medicare UPIN