Provider Demographics
NPI:1811989817
Name:WENZEL, CARL THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:THOMAS
Last Name:WENZEL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1200 OLD YORK RD
Mailing Address - Street 2:DIXON BUILDING, SUITE #201
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3720
Mailing Address - Country:US
Mailing Address - Phone:215-441-6650
Mailing Address - Fax:215-441-6830
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:DIXON BUILDING, SUITE #201
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-6839
Practice Address - Fax:215-481-3515
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2018-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006929L207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F76663Medicare UPIN
PA761048Medicare PIN