Provider Demographics
NPI:1346236130
Name:WENZINGER, ELAINE MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:MARIA
Last Name:WENZINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELAINE
Other - Middle Name:MARIA
Other - Last Name:KIMMEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:759 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-1127
Mailing Address - Country:US
Mailing Address - Phone:540-459-1287
Mailing Address - Fax:540-459-1293
Practice Address - Street 1:1000 N SHENANDOAH AVE
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3547
Practice Address - Country:US
Practice Address - Phone:540-636-0296
Practice Address - Fax:540-636-0259
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039018207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X495W01Medicare PIN
E48558Medicare UPIN