Provider Demographics
NPI:1285633545
Name:WENDT, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:WENDT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:2339 MCCALLIE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3209
Mailing Address - Country:US
Mailing Address - Phone:423-508-6733
Mailing Address - Fax:423-508-6744
Practice Address - Street 1:2339 MCCALLIE AVE STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3209
Practice Address - Country:US
Practice Address - Phone:423-508-6733
Practice Address - Fax:423-508-6744
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN25998207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3086380Medicaid
TNA03341Medicare UPIN
TN3086380Medicaid