Healthcare Provider Details

I. General information

NPI: 1750379426
Provider Name (Legal Business Name): ROBERT E. WERTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CETRONIA RD SUITE 303
ALLENTOWN PA
18104-9168
US

IV. Provider business mailing address

250 CETRONIA RD SUITE 303
ALLENTOWN PA
18104-9168
US

V. Phone/Fax

Practice location:
  • Phone: 610-973-6200
  • Fax: 610-973-6545
Mailing address:
  • Phone: 610-973-6200
  • Fax: 610-973-6545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD055459L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: