Healthcare Provider Details

I. General information

NPI: 1568564342
Provider Name (Legal Business Name): DOUGLAS WENGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 COLLIER DR
DOYLESTOWN OH
44230-1208
US

IV. Provider business mailing address

153 COLLIER DR
DOYLESTOWN OH
44230-1208
US

V. Phone/Fax

Practice location:
  • Phone: 330-658-1550
  • Fax: 330-658-1699
Mailing address:
  • Phone: 330-658-1550
  • Fax: 330-658-1699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35085336
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: