Provider Demographics
NPI:1407836703
Name:WENRICH, RODNEY ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:ALLEN
Last Name:WENRICH
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 1:1346 S DIVISION ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-7021
Mailing Address - Country:US
Mailing Address - Phone:410-749-2599
Mailing Address - Fax:
Practice Address - Street 1:1346 S DIVISION ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-7021
Practice Address - Country:US
Practice Address - Phone:410-749-2599
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD15384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD72316Medicare UPIN
MD917MJ091Medicare ID - Type Unspecified