Provider Demographics
NPI:1467432229
Name:REYMOND, WENDELIN K (MD)
Entity Type:Individual
Prefix:
First Name:WENDELIN
Middle Name:K
Last Name:REYMOND
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:413-794-1629
Practice Address - Street 1:3400 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1113
Practice Address - Country:US
Practice Address - Phone:413-794-9560
Practice Address - Fax:413-794-5884
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2020-02-10
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Provider Licenses
StateLicense IDTaxonomies
MA152825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-2945394OtherPIONEER
MA152825OtherCONNECTICARE
MA2156105Medicaid
MA2854OtherFALLON
MA71293OtherHARVARD PILGRIM
MA152825OtherTUFTS
MA04-2945394OtherGREAT-WEST
MA3295413OtherCIGNA
MA50179OtherBMC
MAJ17403OtherBCBS MA
MA23830OtherHEALTH NEW ENGLAND
MA2111818OtherAETNA
MA04-2945394OtherPIONEER
MA152825OtherTUFTS
G05930Medicare UPIN