Healthcare Provider Details

I. General information

NPI: 1376538843
Provider Name (Legal Business Name): SCOTT M WENDLAND D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 WALLACE RD STE A400
NASHVILLE TN
37211-4983
US

IV. Provider business mailing address

2801 CHARLOTTE AVE
NASHVILLE TN
37209-4035
US

V. Phone/Fax

Practice location:
  • Phone: 615-331-8281
  • Fax: 615-331-3043
Mailing address:
  • Phone: 615-250-9200
  • Fax: 615-331-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number3916
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: