Provider Demographics
NPI:1568461754
Name:WENTZ, CHRISTOPHER M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:WENTZ
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:UPMC PHYSICIAN SERVICES
Mailing Address - Street 2:200 LOTHROP STREET
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-232-9030
Mailing Address - Fax:412-232-9036
Practice Address - Street 1:1350 LOCUST STREET, FIRST FLOOR, SUITE 100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219
Practice Address - Country:US
Practice Address - Phone:412-232-9030
Practice Address - Fax:412-232-9036
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072770L207RC0000X, 207UN0901X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012371990004Medicaid
OH2589168Medicaid
PA1012371990001Medicaid
WV3810005343Medicaid
PA072019NJ5Medicare PIN
PA072019QJDMedicare PIN
PA072019PV1Medicare PIN
PAP00285834Medicare PIN
WV3810005343Medicaid