Individual
CARL FRANK WENTZEL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5818 HARBOUR VIEW BLVD, SUFFOLK, VA 23435-3315
(757) 673-5800
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
(865) 292-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101047910
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700813813
—
VA
01
—
P00343469
RAILROAD MEDICARE
VA
Enumeration date
06/26/2006
Last updated
11/07/2007
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