Healthcare Provider Details

I. General information

NPI: 1841869252
Provider Name (Legal Business Name): JOSHUA WENDLING PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30701 WOODWARD AVE STE 301
ROYAL OAK MI
48073-0987
US

IV. Provider business mailing address

29992 NORTHWESTERN HWY STE C
FARMINGTON HILLS MI
48334-3292
US

V. Phone/Fax

Practice location:
  • Phone: 248-861-2710
  • Fax: 248-861-2709
Mailing address:
  • Phone: 248-851-1430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601013928
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number5601013928
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: