Individual
WENTAO MI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
2451 INTELLIPLEX DR STE 250, SHELBYVILLE, IN 46176-8581
(317) 398-5267
(317) 401-2211
Mailing address
1010 MAIN ST FL 2, BUFFALO, NY 14202-1102
(716) 829-5060
(716) 829-5051
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01096384A
IN
2084N0600X
Clinical Neurophysiology Physician
01096384A
IN
Other
Enumeration date
06/07/2019
Last updated
04/30/2025
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