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Individual

JOSEPH HAROLD WENTZKY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
340 MEDICAL PKWY, SUITE 200, GREER, SC 29650-2441
(864) 797-9400
(864) 797-9402
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10427
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104274
SC
01
576007863006
BCBS
SC
01
P00615797
RAILROAD MEDICARE
SC
01
P00801272
RR MEDICARE
SC
Enumeration date
08/12/2005
Last updated
12/16/2013
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