Provider Demographics
NPI:1043634173
Name:WREN, GARRETT MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:MICHAEL
Last Name:WREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 KOGER CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4778
Mailing Address - Country:US
Mailing Address - Phone:804-897-2100
Mailing Address - Fax:
Practice Address - Street 1:1212 KOGER CENTER BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4778
Practice Address - Country:US
Practice Address - Phone:804-897-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258748207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology