Individual
KEVIN RICHARD WANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11725 POINTE PL, ROSWELL, GA 30076-4636
(470) 990-9483
(877) 800-5436
Mailing address
888 S HILLHURST RD, RIDGEFIELD, WA 98642-9063
(754) 300-3120
(954) 306-8977
Taxonomy
Speciality
Code
Description
License number
State
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
Primary
92660
GA
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004007100
—
FL
Enumeration date
03/30/2007
Last updated
01/08/2025
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