# KEVIN RICHARD WANDLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1205956265
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083A0300X | Addiction Medicine (Preventive Medicine) Physician | 25MA10809300 | NJ | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 01092373A | IN | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 130525 | OH | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 2022048625 | MO | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 25MA10809300 | NJ | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 92660 | GA | Yes |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | DR.0055465 | CO | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | MD60562814 | WA | — |
| 2084P0800X | Psychiatry Physician | 14421 | AZ | — |
| 2084P0800X | Psychiatry Physician | ME110716 | FL | — |

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 01/08/2025