Provider Demographics
NPI:1699826180
Name:GARRITY, WENDY LOCKE (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:LOCKE
Last Name:GARRITY
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 1:15718 FIRE LIGHT PL
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-1617
Mailing Address - Country:US
Mailing Address - Phone:804-739-1530
Mailing Address - Fax:
Practice Address - Street 1:4902 MILLRIDGE PKWY E
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4828
Practice Address - Country:US
Practice Address - Phone:804-744-1231
Practice Address - Fax:804-744-9521
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101221239208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics