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Individual
MICHAEL DAVID WESSON
Active
Individual
MICHAEL DAVID WESSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC0843
FL
152W00000X
Optometrist
Primary
OPT002219
GA
152W00000X
Optometrist
R117-TA-093
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084066100
—
FL
01
—
20767
BLUE CROSS BLUE SHIELD
FL
01
—
20767A
MEDICARE ID - TYPE UNSPECIFIED
FL
Enumeration date
03/31/2006
Last updated
04/22/2022
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