Wynchrister Enriquez

Individual provider Active NPI Pediatrics Physician · Pago Pago, AS

NPI 1659019057 · NPPES record last updated May 25, 2022

Key facts

NPI
1659019057
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
4137C (AS)
Practice address
11155 Turner Drive
Pago Pago, AS 96799-0010
Phone
(684) 633-1222
Fax
(684) 633-1869
NPI assigned
May 25, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4137CASMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4137C AS Yes

Addresses

Primary practice location

11155 Turner Drive
Pago Pago, AS 96799-0010

Mailing address

PO Box LBJ
Pago Pago, AS 96799-0010
Phone (684) 633-1222

Other providers in Pago Pago, AS

All providers in Pago Pago, AS · Pediatrics Physician in American Samoa

Sources for this page

Verify at the official NPI Registry.