Provider Demographics
NPI:1609194232
Name:WEXLER, KYLE WILLIAM
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:WILLIAM
Last Name:WEXLER
Suffix:
Gender:M
Credentials:
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 34599
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20827-0599
Mailing Address - Country:US
Mailing Address - Phone:240-620-5847
Mailing Address - Fax:301-571-1921
Practice Address - Street 1:10412 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 401
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3366
Practice Address - Country:US
Practice Address - Phone:240-620-5847
Practice Address - Fax:301-571-1921
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker