Provider Demographics
NPI:1386637254
Name:WEXLER, DAVID E (MD FACG)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:WEXLER
Suffix:
Gender:M
Credentials:MD FACG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 RARITAN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-2229
Mailing Address - Country:US
Mailing Address - Phone:732-499-8000
Mailing Address - Fax:732-396-9413
Practice Address - Street 1:727 RARITAN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-2229
Practice Address - Country:US
Practice Address - Phone:732-499-8000
Practice Address - Fax:732-396-9413
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2015-02-24
Deactivation Date:2006-03-31
Deactivation Code:
Reactivation Date:2007-11-07
Provider Licenses
StateLicense IDTaxonomies
NJMA039198174400000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ420595Medicare PIN
NJC54201Medicare UPIN