Provider Demographics
NPI:1144772195
Name:JULIE A WENDT MD PLLC
Entity Type:Organization
Organization Name:JULIE A WENDT MD PLLC
Other - Org Name:RELIEVE ALLERGY, ASTHMA & HIVES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WENDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-290-6902
Mailing Address - Street 1:PO BOX 28634
Mailing Address - Street 2:7339 E. WILLIAMS DRIVE
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-0160
Mailing Address - Country:US
Mailing Address - Phone:480-500-1902
Mailing Address - Fax:
Practice Address - Street 1:21803 N SCOTTSDALE RD
Practice Address - Street 2:STE 200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7438
Practice Address - Country:US
Practice Address - Phone:480-500-1902
Practice Address - Fax:480-500-1909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ229693Medicaid
AZ229693Medicaid