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Export Provider Record NPI 1174181630
Eileen WegenerMD
Active
NPI Number1174181630
NPI TypeNPI-1 Individual
SpecialtyInternal Medicine
Provider Details
NPI1174181630
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2019-05-30
Last Updated2022-09-23
Mailing Address170 Governors Ave
Medford, MA 02155-1643
United States
Phone: (781) 306-6102
📍 View Map
Primary Practice Address170 Governors Ave
Medford, MA 02155-1643
United States
Phone: (781) 306-6102
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No390200000X – Student in an Organized Health Care Education/Training Program--
Yes207R00000X – Internal MedicineMA295103
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About NPI 1174181630

Eileen Wegener MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174181630. The primary specialty listed is Internal Medicine. The provider is located in Medford, MA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2019-05-30. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1174181630?

NPI 1174181630 belongs to Eileen Wegener MD, a Internal Medicine in Medford, MA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1174181630 active?

The current status of NPI 1174181630 in the NPPES registry is Active. The record was last updated on 2022-09-23.

What specialty is NPI 1174181630?

NPI 1174181630 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1174181630?

You can verify NPI 1174181630 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1174181630?

The primary practice address on file for NPI 1174181630 is 170 Governors Ave, Medford, MA 02155-1643. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1174181630 issued?

NPI 1174181630 was first issued (enumerated) on 2019-05-30. The NPPES record was last updated on 2022-09-23.

Practice Location Map

Eileen Wegener is located at 170 Governors Ave, Medford, MA. Use the map below to find directions or verify the practice location.

📍 170 Governors Ave, Medford, MA 02155-1643  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Eileen Wegener. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1174181630. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Internal Medicine295103MA
Data Verified from CMS NPPES Last synced: 2026-07-09 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162