Provider Demographics
NPI:1386628022
Name:WEXLER, DAVID B (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:WEXLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:157 UNION ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1228
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217609207YS0012X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA20010OtherHARVARD PILGRIM HEALTHCAR
J27223OtherBLUE SHIELD INDEMNITY
042472266OtherONE HEALTH PLAN
1419607OtherCIGNA HEALTH PLAN
2225835OtherFIRST HEALTH
67885OtherFALLON COMMUNITY HEALTH P
A36426OtherMEDICARE B
2035430OtherMEDICAID/WELFARE
F82236Medicare UPIN
419344OtherTUFTS HEALTH PLAN
J27223OtherBLUE SHIELD HMO BLUE
784104OtherMVP HEALTH CARE
J27223OtherBLUE CARE ELECT
MA2035430Medicaid
MAA36426Medicare ID - Type Unspecified
042472266OtherHEALTHCARE VALUE MANAGEME
042472266OtherTHREE RIVERS
4536675OtherAETNA
1000410OtherEVERCARE