Individual
DR. PAUL B WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
425 ESSJAY RD STE 180, WILLIAMSVILLE, NY 14221
(716) 630-1140
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-5782
(716) 630-1219
(716) 817-1726
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
179282-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010190601
UNIVERA
NY
01
—
000523271001
HEALTH NOW
NY
01
—
0021748
GHI
NY
05
—
01480299
—
NY
01
—
0306229
IHA
NY
01
—
070008309
RR MEDICARE
NY
01
—
161000580
NOVA
NY
01
—
179282-9W
WORKERS COMPENSATION
NY
Enumeration date
05/12/2006
Last updated
12/20/2021
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