Provider Demographics
NPI:1831164292
Name:WENZEL, PAUL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:WENZEL
Suffix:
Gender:
Credentials:MD
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Mailing Address - Street 1:816 INDEPENDENCE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455
Mailing Address - Country:US
Mailing Address - Phone:757-363-6800
Mailing Address - Fax:757-363-6488
Practice Address - Street 1:816 INDEPENDENCE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455
Practice Address - Country:US
Practice Address - Phone:757-363-6800
Practice Address - Fax:757-363-6488
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2025-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101041897207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E50750Medicare UPIN