Provider Demographics
NPI:1609193366
Name:KLEIN, WESLEY NEAL (DO)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:NEAL
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 CAMP ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3048
Mailing Address - Country:US
Mailing Address - Phone:774-470-1370
Mailing Address - Fax:508-484-1777
Practice Address - Street 1:68 CAMP ST STE 1
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3048
Practice Address - Country:US
Practice Address - Phone:774-470-1370
Practice Address - Fax:508-484-1777
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA244640207Q00000X, 2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001689701Medicare PIN