Doctor Name: | CRAIG D WENDT |
NPI Number: | 1174550206 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 050053 |
Business Practice Address: | 14695 Park Ave Charlevoix, MI - 497201929 |
Business Phone Number: | 2315472812 |
Business Fax Number: | 2315473067 |
Mailing Address: | 14695 Park Ave, CHARLEVOIX |
State: | MI |
Postal Code: | 497201929 |
Phone Number: | 2315472812 |
Fax Number: | 2315473067 |
NPI Enumeration Date: | 06/26/2006 |
NPI Last Update Date: | 02/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 050053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |