Individual
DR. ROBERT T WECHSLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD, FAAN
Contact information
Practice address
1499 W. HAYS ST., BOISE, ID 83702
(208) 275-8585
(208) 275-8586
Mailing address
1499 WEST HAYS STREET, BOISE, ID 83702
(208) 381-7353
(208) 381-7354
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
M9221
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010151186
REGENCE BLUE SHIELD
ID
01
—
75135
BLUE CROSS OF IDAHO
ID
05
—
807254700
—
ID
05
—
807254701
—
ID
Enumeration date
09/20/2005
Last updated
01/07/2015
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