Healthcare Provider Details

I. General information

NPI: 1922235043
Provider Name (Legal Business Name): HOWARD H WURTZEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 06/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 EISENHOWER DR
SAVANNAH GA
31406-5027
US

IV. Provider business mailing address

1915 EISENHOWER DR
SAVANNAH GA
31406-5027
US

V. Phone/Fax

Practice location:
  • Phone: 912-356-2562
  • Fax: 912-351-3538
Mailing address:
  • Phone: 912-356-2562
  • Fax: 912-351-3538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number051006
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: