Provider Demographics
NPI:1770699290
Name:WETZEL, JENNIFER T (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:T
Last Name:WETZEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:610 OLD YORK ROAD
Mailing Address - Street 2:SUITE 70
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:215-887-3100
Mailing Address - Fax:215-572-3946
Practice Address - Street 1:610 OLD YORK ROAD
Practice Address - Street 2:SUITE 70
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-887-3100
Practice Address - Fax:215-572-3946
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD427128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine