Healthcare Provider Details

I. General information

NPI: 1356789101
Provider Name (Legal Business Name): CHRISTOPHER WENZINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2013
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MEDICAL CENTER CIR STE 309
FISHERVILLE VA
22939-2273
US

IV. Provider business mailing address

70 MEDICAL CENTER CIR STE 309
FISHERVILLE VA
22939-2273
US

V. Phone/Fax

Practice location:
  • Phone: 540-332-5885
  • Fax: 540-332-5888
Mailing address:
  • Phone: 540-332-5885
  • Fax: 540-332-5888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberLL35849
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: