Provider Demographics
NPI:1578318564
Name:INSKO, WESLEY J (PA)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:J
Last Name:INSKO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5223
Mailing Address - Country:US
Mailing Address - Phone:207-776-8824
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST RM 1000
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-3913
Practice Address - Country:US
Practice Address - Phone:844-780-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA64382363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant