Provider Demographics
NPI:1982766325
Name:WESLER, LEE SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:SCOTT
Last Name:WESLER
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 1:612 HARTFORD PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06241
Mailing Address - Country:US
Mailing Address - Phone:860-779-0867
Mailing Address - Fax:860-779-0386
Practice Address - Street 1:612 HARTFORD PIKE
Practice Address - Street 2:
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241
Practice Address - Country:US
Practice Address - Phone:860-779-0867
Practice Address - Fax:860-779-0386
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT029249207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001292490Medicaid
CT001292490Medicaid
B39169Medicare UPIN