Organization
D. E. WENNER III, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD E WENNER III M.D. (OWNER/PRESIDENT)
15756231980
Entity
Organization
Contact information
Practice address
1600 SE MAIN ST, SUITE F, ROSWELL, NM 88203-5423
(575) 623-1980
Mailing address
1600 SE MAIN ST, SUITE F, ROSWELL, NM 88203-5423
(575) 623-1980
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD2012-0816
NM
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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