Individual
AMY L. WRENTMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
LEE ST FL 4, CHARLOTTESVILLE, VA 22908-0001
(434) 924-5321
(434) 982-3816
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101241326
VA
208000000X
Pediatrics Physician
12445
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104869767
—
VA
05
—
30204717
—
NH
Enumeration date
06/13/2006
Last updated
11/28/2012
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