Individual
DR. MICHAEL W. WENTWORTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
47149 BUSE RD, BLDG 1370, PATUXENT RIVER, MD 20670-1540
(301) 342-9503
(301) 342-4718
Mailing address
47149 BUSE RD, BLDG 1370, PATUXENT RIVER, MD 20670-1540
(301) 342-9503
(301) 342-4718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101059065
VA
Other
Enumeration date
01/04/2006
Last updated
07/08/2007
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