Provider Demographics
NPI:1063457596
Name:WENOCUR, HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:WENOCUR
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 1:2500 MARYLAND RD STE 504
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1226
Mailing Address - Country:US
Mailing Address - Phone:215-481-6836
Mailing Address - Fax:215-481-5788
Practice Address - Street 1:9501 ROOSEVELT BLVD STE 206B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1027
Practice Address - Country:US
Practice Address - Phone:215-671-8900
Practice Address - Fax:215-671-1272
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD43688E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine