Provider Demographics
NPI:1578649927
Name:HANDLER, WENDY ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ELLEN
Last Name:HANDLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 RESEARCH PARK DR
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4873
Mailing Address - Country:US
Mailing Address - Phone:410-402-2258
Mailing Address - Fax:410-204-7279
Practice Address - Street 1:7440 SPRING VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-4446
Practice Address - Country:US
Practice Address - Phone:703-923-4644
Practice Address - Fax:703-923-4625
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051060207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F86855Medicare UPIN
VAG02083Medicare PIN