Provider Demographics
NPI:1417934704
Name:WENZEL, ROBERT BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRIAN
Last Name:WENZEL
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:ATTN: CREDENTIALS OFFICE
Mailing Address - Street 2:CMR 442
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09042
Mailing Address - Country:DE
Mailing Address - Phone:49622-117-2274
Mailing Address - Fax:49622-117-2941
Practice Address - Street 1:BUTZBACH HEALTH CLINIC
Practice Address - Street 2:CMR 452
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09161
Practice Address - Country:DE
Practice Address - Phone:49603-398-2114
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT324555-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine