MEDICARE: DR. WENDRA JANE GALFAND D.O.

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	207Q00000X	Family Medicine Physician	67020	GA

General Provider Information

NPI Number	:	1770850695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDRA JANE GALFAND D.O.

Provider Business Mailing Address
First Line	:	2750 GLIDER ST APT 203
Second Line	:
City	:	FORT LIBERTY
State	:	NC
Zip	:	28307-2761
Country	:	US
Telephone Number	:	610-745-0460
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 GLIDER ST APT 203
Second Line	:
City	:	FORT LIBERTY
State	:	NC
Zip	:	28307-2761
Country	:	US
Telephone Number	:	610-745-0460
Fax Number	:

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

Provider Enumeration Date	:	11/21/2011
Last Update Date	:	12/27/2023

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