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Individual

DR. GEN WEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-2019
(570) 214-9585
(570) 214-9519
Mailing address
100 N ACADEMY AVE, CREDENTIALS DEPT, DANVILLE, PA 17822-4903
(570) 271-6144

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD443986
PA
208M00000X
Hospitalist Physician
MD443986
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1026301670001
PA
Enumeration date
10/15/2008
Last updated
12/03/2014
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