Healthcare Provider Details

I. General information

NPI: 1477238228
Provider Name (Legal Business Name): BENJAMIN PETER WENGER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SPEAR ST
OXFORD PA
19363-1655
US

IV. Provider business mailing address

620 SPEAR ST
OXFORD PA
19363-1655
US

V. Phone/Fax

Practice location:
  • Phone: 610-932-9300
  • Fax: 610-932-5283
Mailing address:
  • Phone: 610-932-9300
  • Fax: 610-932-5283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS026156
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: