Individual
DR. DARRYL CHARLES DANIEL WENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
224 E MAIN ST, SPRINGVILLE, NY 14141-1443
(716) 592-2871
Mailing address
6075 POPLAR AVE, SUITE 401, MEMPHIS, TN 38119-4740
(716) 863-7948
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
269910
NY
208M00000X
Hospitalist Physician
269910
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
06/13/2011
Last updated
05/22/2015
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