Provider Demographics
NPI:1821153065
Name:WIMMER, NEIL JASON (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:JASON
Last Name:WIMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:252 CHAPMAN RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5436
Mailing Address - Country:US
Mailing Address - Phone:302-623-1929
Mailing Address - Fax:302-366-1075
Practice Address - Street 1:252 CHAPMAN RD
Practice Address - Street 2:SUITE 150
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5436
Practice Address - Country:US
Practice Address - Phone:302-623-1929
Practice Address - Fax:302-366-1075
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0011303207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease