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Individual

DANIEL WENDELIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
37630
KY
207NS0135X
Procedural Dermatology Physician
37630
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2443573000
PASSPORT ADVANTAGE
KY
01
50002034
PASSPORT
KY
05
64060932-00
KY
Enumeration date
10/11/2006
Last updated
06/09/2020
Update your record

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