Individual
MICHAEL THOMAS WENZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 E. HIRST ROAD, SUITE 200, PURCELLVILLE, VA 20132-6199
(540) 338-6101
(540) 338-7803
Mailing address
224 D CORNWALL STREET NW, STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101048465
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010086779
—
VA
05
—
1437143971
—
VA
05
—
30016052980001
—
VA
01
—
P00174012
RR MEDICARE
—
Enumeration date
09/09/2005
Last updated
03/18/2024
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