Individual
STANLEY WIRSIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
874 PURCHASE ST, GREATER NEW BEDFORD COMMUNITY HEALTH CENTER, NEW BEDFORD, MA 02740-6232
(508) 992-6553
(508) 990-7558
Mailing address
874 PURCHASE ST, NEW BEDFORD, MA 02740-6232
(508) 992-6553
(508) 990-7558
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
903
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013376
NEIGHBORHOOD HEALTH PLAN
MA
01
—
32953-2
BCBSRI
RI
01
—
408335
BLUE CHIP
RI
01
—
80894
FALLON
MA
Enumeration date
05/04/2007
Last updated
11/14/2007
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