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Individual
DR. TRACY ELIZABETH WIMBUSH
Active
Individual
DR. TRACY ELIZABETH WIMBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD433123
PA
207P00000X
Emergency Medicine Physician
213411
MA
207P00000X
Emergency Medicine Physician
243910
NY
207P00000X
Emergency Medicine Physician
MD433123
PA
208VP0000X
Pain Medicine Physician
Primary
068869
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134595J
—
GA
05
—
003134595K
—
GA
05
—
003134595L
—
GA
05
—
2034247
—
MA
01
—
468709
TUFTS HEALTH PLAN
MA
01
—
J27108
BCBS MA
MA
Enumeration date
12/13/2005
Last updated
06/03/2014
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