Provider Demographics
NPI:1700871423
Name:WESTER, TRENT WESLEY (MD)
Entity Type:Individual
Prefix:
First Name:TRENT
Middle Name:WESLEY
Last Name:WESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3324 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-9232
Mailing Address - Country:US
Mailing Address - Phone:252-237-7770
Mailing Address - Fax:252-291-7779
Practice Address - Street 1:3324 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-9232
Practice Address - Country:US
Practice Address - Phone:252-237-7770
Practice Address - Fax:252-291-7779
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCI09333Medicare UPIN
NC2030674Medicare PIN