Provider Demographics
NPI:1730381724
Name:WETHLI, MARY CHRISTINE (DO)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:CHRISTINE
Last Name:WETHLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:406 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-1404
Mailing Address - Country:US
Mailing Address - Phone:814-827-1851
Mailing Address - Fax:814-827-2031
Practice Address - Street 1:406 W OAK ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-1404
Practice Address - Country:US
Practice Address - Phone:814-827-1851
Practice Address - Fax:814-827-2031
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006733L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE93138Medicare UPIN
PAE93138Medicare UPIN