Provider Demographics
NPI:1679663959
Name:WRENSFORD, GLENDA C (MD)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:C
Last Name:WRENSFORD
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:USAMEDDAC WUERZBURG UNIT 26610
Mailing Address - Street 2:ATTN: CREDENTIALS OFFICE
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USAMEDDAC WUERZBURG UNIT 26610
Practice Address - Street 2:ATTN: CREDENTIALS OFFICE
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09244
Practice Address - Country:US
Practice Address - Phone:01149931-804-3932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 13939208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice