Basic Information
| Provider Information | |||||||||
| NPI: | 1265540975 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WERTHEIMER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 BLUE HILL DR 2B | ||||||||
| Address2: | |||||||||
| City: | WESTWOOD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020902161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177541057 | ||||||||
| FaxNumber: | 6177541040 | ||||||||
| Practice Location | |||||||||
| Address1: | UMASS MEMORIAL HEALTH CARE | ||||||||
| Address2: | 119 BELMONT STREET | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083345132 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 07/20/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086X0206X | 34387 | MA | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology |
No ID Information.