Individual
DR. WYNN A PERLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
111 WILLARD ST, SUITE 2F, QUINCY, MA 02169-1200
(617) 773-2313
(617) 328-3861
Mailing address
111 WILLARD ST, SUITE 2F, QUINCY, MA 02169-1200
(617) 773-2313
(617) 328-3861
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2053
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002053
TUFTS MEDICARE PREFERRED
—
01
—
042297845
GREAT WEST HEALTH CARE
—
01
—
043376631
GIC
—
01
—
0620074
AETNA
—
01
—
1215062
FALLON
—
01
—
27 00004
UNITED HEALTH CARE
—
01
—
334257
HARVARD PILGRIM
—
01
—
33917
HARVARD PILGRIM
—
01
—
5297190
AETNA
—
01
—
Y71014
BLUE CROSS
MA
01
—
Y77182
BLUE CROSS
MA
Enumeration date
10/13/2006
Last updated
10/13/2011
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