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Individual

ALLEN RICHARD WENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4711 SUNSET BLVD, AGAPE PHYSICIANS CARE, LEXINGTON, SC 29072-9151
(803) 356-3609
(803) 451-6135
Mailing address
1624 MAIN STREET, AGAPE SENIOR PRIAMARY CARE, INC., DBA AGAPE PHYSICIANS, COLUMBIA, SC 29201
(803) 454-0365
(803) 404-6000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
07472
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
74724
SC
Enumeration date
12/08/2006
Last updated
09/08/2014
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