Provider Demographics
NPI:1326252024
Name:ARNOLD, WENDY TORRES (NP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:TORRES
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 OLD SPARTANBURG RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-4105
Mailing Address - Country:US
Mailing Address - Phone:864-268-1119
Mailing Address - Fax:864-268-1714
Practice Address - Street 1:4501 OLD SPARTANBURG RD
Practice Address - Street 2:SUITE 14
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-4105
Practice Address - Country:US
Practice Address - Phone:864-268-1119
Practice Address - Fax:864-268-1714
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNP93207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP0302Medicare UPIN