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Philip
Wexler
MD
Contract Details
Shepherd Center
Facility name
Provider ID
P000000001
NPI
1932175700
Tax ID
510141601
Effective Date
12/21/2020
Last Updated
12/21/2020
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_389
Exhibit Attachment
Location Details
Address
2020 Peachtree Road Northwest
Atlanta, GA 30309
United States
Phone
404-352-2020
(
Phone
)
Billing Details
Address
2020 Peachtree Road Northwest
Atlanta, GA 30309
Billing Phone
404-352-2020
Specialty Type
Pulmonary Diseases
Map
Address