Provider Demographics
NPI:1861498990
Name:WOPPERER, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:WOPPERER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5320 MILITARY RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-2149
Mailing Address - Country:US
Mailing Address - Phone:716-297-1701
Mailing Address - Fax:716-297-1479
Practice Address - Street 1:5320 MILITARY RD
Practice Address - Street 2:SUITE 107
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-2149
Practice Address - Country:US
Practice Address - Phone:716-297-1701
Practice Address - Fax:716-297-1479
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2009-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY155653174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0454390001OtherMEDICARE-DME
NY0903962OtherINDEPENDENT HEALTH
NY000510318001OtherBLUE CROSS OF WNY
NY0022755OtherGROUP HEALTH INSURANCE
NY00010290601OtherUNIVERA HEALTHCARE
NY0022755OtherGROUP HEALTH INSURANCE
NY00010290601OtherUNIVERA HEALTHCARE