MEDICARE: WALLACE EDWARD WENGLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME0033979	FL
2	2086X0206X	Surgical Oncology Physician	ME33979	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073511408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALLACE EDWARD WENGLER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 417
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34995-0417
Country	:	US
Telephone Number	:	772-223-5665
Fax Number	:	772-223-5646

Provider Business Practice Location Address
First Line	:	509 SE RIVERSIDE DR STE 200
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-2579
Country	:	US
Telephone Number	:	772-219-4026
Fax Number	:	772-219-0973

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	10/13/2020

Similar Medicare Providers

1518962836 — DR. JEFFREY A DISKIN M.D.
Practice Location Address:

509 SE RIVERSIDE DR STE 302
STUART, FL
34994-2579

Practice Phone: 772-287-9000
Practice Fax: 772-287-0507

1568468437 — CLARENCE RICHARD GRAVES III PA-C
Practice Location Address:

509 SE RIVERSIDE DR , SUITE 203
STUART, FL
34994-2579

Practice Phone: 772-288-5862
Practice Fax: 772-288-5874

1083611776 — ANIS Y AKRAWI M.D.
Practice Location Address:

509 SE RIVERSIDE DR STE 203
STUART, FL
34994-2579

Practice Phone: 772-286-1555
Practice Fax: 772-287-2140

1346225984 — JOHN R ROBINSON MD
Practice Location Address:

509 SE RIVERSIDE DR , STE 203
STUART, FL
34994-2579

Practice Phone: 772-223-5665
Practice Fax: 772-223-5646

1326024902 — DR. KIMBERLY SUE WYATT MD
Practice Location Address:

509 SE RIVERSIDE DR STE 303
STUART, FL
34994-2579

Practice Phone: 772-283-9111
Practice Fax: 772-781-2785

1255301362 — DR. PAUL N. SCHACKNOW M.D., PH.D.
Practice Location Address:

509 SE RIVERSIDE DR STE 302
STUART, FL
34994-2579

Practice Phone: 772-287-9000
Practice Fax: 772-287-0507

Directions to “ WALLACE EDWARD WENGLER M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.