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Organization

WJG MULTISPECIALTY CLINIC PC

Active
Other names
Local Infusion
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES MICHAEL BUCY (SENIOR REIMBURSEMENT MANAGER)
(717) 383-0392
Entity
Organization

Contact information

Practice address
194 PLEASANT ST STE 7, CONCORD, NH 03301-2952
(603) 208-3085
(603) 217-5371
Mailing address
PO BOX 53302, PHOENIX, AZ 85072-3302
(844) 614-2354
(844) 278-8635

Taxonomy

Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
208VP0000X
Pain Medicine Physician
208VP0014X
Interventional Pain Medicine Physician
261QI0500X
Infusion Therapy Clinic/Center
Primary
261QM1300X
Multi-Specialty Clinic/Center
363L00000X
Nurse Practitioner

Other

Enumeration date
07/21/2022
Last updated
04/23/2026
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