Provider Demographics
NPI:1104519966
Name:WEXFORD HEALTH SOLUTIONS
Entity type:Organization
Organization Name:WEXFORD HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NILAY
Authorized Official - Middle Name:B
Authorized Official - Last Name:THAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-730-0302
Mailing Address - Street 1:4006 CANDLE LIGHT DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MD
Mailing Address - Zip Code:21036-1141
Mailing Address - Country:US
Mailing Address - Phone:630-730-0302
Mailing Address - Fax:
Practice Address - Street 1:94 GRAPEVINE RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-3434
Practice Address - Country:US
Practice Address - Phone:630-730-0302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty