Provider Demographics
NPI:1609920404
Name:WEHLE, DANIELLE MARIE (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:MARIE
Last Name:WEHLE
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 MONTCLAIR RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2417
Mailing Address - Country:US
Mailing Address - Phone:205-705-3550
Mailing Address - Fax:205-705-3554
Practice Address - Street 1:3918 MONTCLAIR RD STE 105
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-2417
Practice Address - Country:US
Practice Address - Phone:205-705-3550
Practice Address - Fax:205-705-3554
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31680207ZD0900X
TN45275207ZD0900X
NC2010-00001207ZD0900X
NY246034-1207ZD0900X
TXP6110207ZP0102X
390200000X
ALMD.41311207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program