Provider Demographics
NPI:1689657686
Name:WYLER, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:WYLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2291 WASHINGTON ST
Mailing Address - Street 2:APT. G
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1426
Mailing Address - Country:US
Mailing Address - Phone:617-964-3960
Mailing Address - Fax:617-527-6737
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:HOSPITALIST SERVICE, 2 NORTH
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-6000
Practice Address - Fax:617-527-6737
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA44458207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA700522OtherTUFTS HEALTH PLAN
MA2092899Medicaid
MAV05362OtherBCBS
MA694789OtherHARVARD PILGRIM HEALTH PL
MA694789OtherHARVARD PILGRIM HEALTH PL
MAD82822Medicare UPIN