Provider Demographics
NPI:1457597809
Name:NORWOOD, WESLEY MESSER (PA)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:MESSER
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S 1000 E STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1496
Mailing Address - Country:US
Mailing Address - Phone:801-363-4071
Mailing Address - Fax:
Practice Address - Street 1:150 S 1000 E STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1496
Practice Address - Country:US
Practice Address - Phone:801-363-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT71812541206363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical