Provider Demographics
NPI:1033355995
Name:WEXLER, NATHAN SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:SAMUEL
Last Name:WEXLER
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 1:6050 ANNUNCIATION ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5707
Mailing Address - Country:US
Mailing Address - Phone:504-897-3088
Mailing Address - Fax:504-891-1326
Practice Address - Street 1:6050 ANNUNCIATION ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5707
Practice Address - Country:US
Practice Address - Phone:504-897-3088
Practice Address - Fax:504-891-1326
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-25
Last Update Date:2008-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010258208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1136271Medicaid
B60650Medicare UPIN