Healthcare Provider Details

I. General information

NPI: 1568461754
Provider Name (Legal Business Name): CHRISTOPHER M WENTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 LOCUST STREET, FIRST FLOOR, SUITE 100
PITTSBURGH PA
15219
US

IV. Provider business mailing address

UPMC PHYSICIAN SERVICES 200 LOTHROP STREET
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-232-9030
  • Fax: 412-232-9036
Mailing address:
  • Phone: 412-232-9030
  • Fax: 412-232-9036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD072770L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberMD072770L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD072770L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: